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Women's perceptions of life after 70 : a phenomenological study Sloss, Theresa Anne 1989

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WOMEN'S PERCEPTIONS OF LIFE AFTER 70: A PHENOMENOLOGICAL STUDY  By THERESA ANNE SLOSS .Sc.N., The U n i v e r s i t y o f B r i t i s h Columbia, 1978  A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN NURSING in THE FACULTY OF GRADUATE STUDIES (The School o f Nursing)  We a c c e p t t h i s t h e s i s as conforming to the required  standard  THE UNIVERSITY OF BRITISH COLUMBIA September 1989 (S) Theresa Anne S l o s s , 1989  In  presenting  degree freely  at  this  the  available  copying  of  department publication  thesis  in  partial  fulfilment  University  of  British  Columbia,  for  this or  reference  thesis by  of  for  his  this  and  scholarly  or  thesis  her  for  of  "0  XJL/S t ^\  The University of British Columbia Vancouver, Canada  Date  DE-6  (2/88)  f  1  '  JO  -  //  I  I further  purposes  gain  the  shall  requirements  agree  that  agree  may  representatives.  financial  permission.  Department  study.  of  be  It not  that  the  be  Library  an  advanced  shall  permission for  granted  is  for  by  understood allowed  the  make  extensive  head  that  without  it  of  copying my  my or  written  ABSTRACT  WOMEN'S PERCEPTIONS OF LIFE AFTER 70: A PHENOMENOLOGICAL STUDY  T h i s study was designed t o g a i n an u n d e r s t a n d i n g of how o l d e r women p e r c e i v e t h e i r l i v e s . In o r d e r t o g a i n t h i s  insight  the q u a l i t a t i v e r e s e a r c h methodology o f phenomenology was selected. Data c o l l e c t i o n and a n a l y s i s o c c u r r e d c o n c u r r e n t l y . Data were c o l l e c t e d through f i f t e e n u n s t r u c t u r e d i n t e r v i e w s . E i g h t women whose ages ranged from 75 t o 88, and who l i v e d on t h e i r own  i n t h e community p a r t i c i p a t e d i n t h e study. Each t r a n s c r i b e d  i n t e r v i e w was a n a l y z e d s e p a r a t e l y and i n r e l a t i o n t o t h e o t h e r i n t e r v i e w s . Emerging themes were v a l i d a t e d and c l a r i f i e d i n t h e second i n t e r v i e w . The themes were s y n t h e s i z e d and then i n t e g r a t e d i n t o t h e f i n a l framework c a l l e d t h e c y c l e of contentment. The c y c l e o f contentment had f o u r phases: h a v i n g independence and connectedness (sources o f contentment), e x p e r i e n c i n g t h r e a t s , c a l l i n g upon r e s o u r c e s and r e d e f i n i n g independence and connectedness. Contentment was a form o f happiness p r e f e r r e d by the women and was c h a r a c t e r i z e d by calmness and freedom from u n e a s i n e s s . Independence and connectedness were i d e n t i f i e d as t h e two main sources o f contentment. Independence was composed o f s e l f r e l i a n c e , n o t h a v i n g t o inconvenience o t h e r s and of b e i n g i n  iii c o n t r o l o f d a i l y events and p e r s o n a l a f f a i r s . Connectedness was equated w i t h a sense o f belonging  w i t h f a m i l y and f r i e n d s and  b e i n g i n v o l v e d and aware o f what was happening i n t h e w o r l d . Unfortunately,  l i f e over 70 f o r these women was accompanied by  many t h r e a t s which d i s r u p t e d t h e i r independence and connectedness and thus t h e i r contentment. The t h r e a t s noted i n the study were: t h e death of a spouse, death o f f r i e n d s , h e a l t h problems and t h e adverse a t t i t u d e s and a c t i o n s o f o t h e r s . In response t o t h e t h r e a t s t h e women c a l l e d upon t h e i r r e s o u r c e s t o counteract  t h e impact of t h e t h r e a t s . Two types o f r e s o u r c e s  were noted i n t h e study: e x t e r n a l and i n t e r n a l . resources  External  i n c l u d e d f i n a n c e s , f a m i l y , f r i e n d s and h e l p f u l  neighbors.  I n t e r n a l resources  confidence,  i n c l u d e d f a i t h , memories, s e l f -  a f i g h t i n g s p i r i t and p e r s o n a l a t t r i b u t e s which were  somewhat unique t o t h i s stage of t h e i r l i v e s . By drawing upon t h e i r resources  i t was p o s s i b l e t o move t o t h e next phase of the  c y c l e , t h a t o f r e d e f i n i n g independence and connectedness. T h i s r e d e f i n i t i o n occurred experiencing  i n t h r e e ways. The women found new ways of  independence and connectedness, they  common t h r e a t s and they r e a p p r a i s e d  normalized  t h e i r s i t u a t i o n s . Once  independence and connectedness were r e d e f i n e d ,  contentment  returned. These f i n d i n g s were d i s c u s s e d i n r e l a t i o n t o r e l e v a n t l i t e r a t u r e . The i m p l i c a t i o n s f o r n u r s i n g p r a c t i c e , e d u c a t i o n and r e s e a r c h were then i d e n t i f i e d .  iv TABLE OF CONTENTS Page ABSTRACT .  i i .  TABLE OF CONTENTS  iv  LIST OF FIGURES  vi  ACKNOWLEDGEMENTS  v i i  CHAPTER 1: INTRODUCTION TO THE STUDY Introduction Background t o t h e Problem Conceptual Framework Problem Statement Purpose Methodology Definitions Assumptions Limitations O r g a n i z a t i o n o f the T h e s i s Summary CHAPTER 2: LITERATURE REVIEW Introduction P r o f i l e o f Women 70 and Over P s y c h o s o c i a l T h e o r i e s o f Aging Research on Women Recent I n f o r m a t i o n on Aging Summary CHAPTER 3 : METHODOLOGY Introduction Overview o f Phenomenology Selection of Participants C r i t e r i a f o r Selection S e l e c t i o n Procedure C h a r a c t e r i s t i c s of the P a r t i c i p a n t s Data C o l l e c t i o n and A n a l y s i s Data A n a l y s i s . . . E t h i c s and Human R i g h t s Summary  1 1 1 5 7 7 7 8 9 9 10 10 ,  11 11 11 12 16 19 21 23 23 . 23 25 25 25 26 26 28 29 30  V  CHAPTER 4: RESEARCH FINDINGS Introduction Contentment Threats , Resources E x t e r n a l Resources I n t e r n a l Resources R e d e f i n i n g Independence and Connectedness Summary  31 31 31 37 41 42 43 49 54  CHAPTER 5: DISCUSSION OF FINDINGS Introduction The Research Questions T h e o r e t i c a l Framework C y c l e o f Contentment Contentment . Independence and Connectedness Experiencing Threats Resources R e d e f i n i n g Independence and Connectedness Summary  56 56 56 58 59 59 60 61 63 66 68  CHAPTER 6: SUMMARY, CONCLUSIONS AND IMPLICATIONS FOR NURSING Introduction Nursing Implications Implications f o r Nursing P r a c t i c e I m p l i c a t i o n s f o r Nursing E d u c a t i o n I m p l i c a t i o n s f o r N u r s i n g Research  70 70 74 74 76 77  REFERENCES .  79  APPENDICES  84  Appendix A: L e t t e r o f I n f o r m a t i o n Appendix B: Consent Form . . * Appendix C: Sample T r i g g e r Questions f o r the I n i t i a l Interview  .  85 87 88  vi LIST OF FIGURES Figure 1. The C y c l e of Contentment  Page 32  yii ACKNOWLEDGEMENTS I wish t o thank t h e v e r y s p e c i a l women who p a r t i c i p a t e d i n ^ t h i s study. T h e i r w i l l i n g n e s s and a b i l i t y t o share t h e i r unique perspectives  were i n v a l u a b l e . To P a u l , who p r o v i d e d  ending supply  an never  of emotional support and computer e x p e r t i s e . To so  many o f my f r i e n d s , and e s p e c i a l l y , Susan, L i n g , C a r o l , Nora and Marion. And f i n a l l y ,  I would l i k e t o acknowledge t h e time,  e f f o r t and a s s i s t a n c e o f my r e s e a r c h A l i s o n Rice external  committee,  Professors  ( c h a i r ) , C l a r i s s a Green and Helen E l f e r t t h e  reader.  1 CHAPTER 1 INTRODUCTION TO THE STUDY  Introduction Canadian endeavors  society i s increasingly successful i n i t s  t o p r e s e r v e and extend human l i f e .  T h i s success i s  evidenced by t h e i n c r e a s i n g numbers of o l d e r people, t h e m a j o r i t y o f whom a r e women. To date, r e s e a r c h e r s have a c q u i r e d a s u b s t a n t i a l amount o f i n f o r m a t i o n d e s c r i b i n g t h e problems and i l l n e s s e s a s s o c i a t e d w i t h o l d age. However, l i t t l e r e s e a r c h e x i s t s about w e l l n e s s i n o l d age, o r about t h e e x p e r i e n c e of l i v i n g through o l d age. In o r d e r t o expand our u n d e r s t a n d i n g o f o l d age, t h e r e i s a need t o g a i n a more h o l i s t i c understanding from o l d e r people's p e r s p e c t i v e s . T h i s study begins t o address t h a t need. I t s aim i s t o d i s c o v e r how a sample o f women over 70, perceive t h e i r l i v e s . Background t o t h e Problem By t h e y e a r 2021, one i n every f i v e Canadians w i l l be over 65 y e a r s o l d . T h i s i s a s i g n i f i c a n t i n c r e a s e from 1931 when 1 in  e v e r y 13 Canadians was over 65 (Hees, 1987). C u r r e n t l y , a  woman o f 65 can expect t o l i v e f o r 19 more y e a r s ; a man can expect 15 more y e a r s o f l i f e  (Hees,  1987).  S i n c e t h e 1950's, t h e r a t i o of women t o men i n t h e o l d e r age group has i n c r e a s e d . While women 75 y e a r s o f age and over outnumbered men 125 t o 100 i n 1956, by 1981 women i n t h i s  group  outnumbered men 195 t o 100 (Stone & F l e t c h e r , 1986). Thus, t h e r e are more v e r y o l d women than men.  2  U n f o r t u n a t e l y , much o f the e x i s t i n g i n f o r m a t i o n p e r t a i n i n g t o women who a r e now aged 65 and over i s both erroneous and l i m i t e d . Erroneous i n f o r m a t i o n a r i s e s from n e g a t i v e  stereotypes  which p o r t r a y o l d e r women as p h y s i c a l l y u n a t t r a c t i v e , unproductive  and dependent on others as they age (Cohen, 1984).  Or, o l d e r women and men may be grouped t o g e t h e r as a s i n g l e homogeneous group a l l s u f f e r i n g from i l l h e a l t h , c o n f u s i o n and unhappiness (Chappel,  S t r a i n & B l a n d f o r d , 1986). These n e g a t i v e  s t e r e o t y p e s n o t o n l y l i m i t our understanding f e e l about l i v i n g i n o l d age,  o f how o l d e r women  but can a l s o i n t e r f e r e w i t h t h e  d e l i v e r y of adequate h e a l t h care  (Rodin & Langer, 1980?  P a n i c u c c i , 1983). So l i t t l e i s known about women over 65 f o r s e v e r a l reasons. F i r s t , r e s e a r c h e r s now r e c o g n i z e t h a t a number o f p r e v i o u s s t u d i e s s u f f e r e d from a male b i a s ( E i c h l e r & L a p i o n t e , 1985; B a r n e t t & Bauch, 1978). T h i s b i a s r e s u l t e d from men having h i g h e r e d u c a t i o n a l l e v e l s and occupying  p o s i t i o n s of power and  s t a t u s , which i n t u r n allowed them t o d e s i g n , implement and i n t e r p r e t r e s e a r c h s t u d i e s from t h e i r own p e r s p e c t i v e s . In a d d i t i o n , many r e s e a r c h e r s i n c o r r e c t l y assumed t h a t t h e f i n d i n g s of  s t u d i e s w i t h e x c l u s i v e l y male s u b j e c t s c o u l d be g e n e r a l i z e d  t o t h e p o p u l a t i o n as a whole. Gender was not c o n s i d e r e d a s o c i a l v a r i a b l e f o r a n a l y s i s ( E i c h l e r & Lapointe, women's p e r s p e c t i v e s tended t o be i g n o r e d Second, some people  suggest  1985). T h e r e f o r e (Gillian,  1985).  t h a t women have been  excluded  from r e s e a r c h s t u d i e s because of t h e i r p e r c e i v e d l a c k o f s t a t u s and power ( B u r w e l l , 1984). F e m i n i s t r e s e a r c h e r s a r e b e g i n n i n g t o  3 look a t o l d e r women's i s s u e s , but t o date most energy has been d i r e c t e d toward t h e i s s u e s a f f e c t i n g younger women ( F e n n e l l , P h i l i p s o n & Evers,  1988). Thus t h e f a i l u r e t o d i f f e r e n t i a t e  gender p e r s p e c t i v e s , a l a c k of r e c o g n i t i o n o f female i s s u e s f o r study, and p a s t e x c l u s i o n from r e s e a r c h  a l l c o n t r i b u t e t o our  l i m i t e d understanding o f today's o l d e r women. Recent demographic data h i g h l i g h t two areas o f concern. In 1982,  60% o f t h e e l d e r l y unattached women i n Canada e x i s t e d a t  o r below t h e p o v e r t y l i n e  (Gee & K i m b a l l ,  1987). These women  have low incomes f o r a v a r i e t y o f reasons. Most  obviously,  m a r r i e d women f r e q u e n t l y become widowed, and f i n d t h a t income i s d r a s t i c a l l y reduced. In a d d i t i o n , i n p r e v i o u s  their decades  many women remained i n t h e home and cared f o r t h e i r f a m i l i e s . They were r a r e l y i n v o l v e d i n out-of-home employment and thus were unable t o accrue savings plans,  o r c o n t r i b u t e t o t h e i r own pension  F i n a l l y , when women, e i t h e r s i n g l e o r m a r r i e d , d i d work  o u t s i d e o f t h e home, they almost i n v a r i a b l y earned l e s s than t h e i r male c o u n t e r p a r t s  which reduced t h e i r a b i l i t y t o  accumulate f i n a n c i a l resources  f o r o l d age (Gee & K i m b a l l ,  1987). Low incomes can o f t e n l e a d t o d i m i n i s h e d and  lowered s e l f - e s t e e m  states of health  f o r o l d e r women (Gee & K i m b a l l , 1987;  Harvey, Barnes, Greenwood & Kabahenda-Nyakabwa, 1987). A second f u r t h e r d i s t u r b i n g t r e n d r e v e a l e d by t h e demographic d a t a ,  concerns c h r o n i c d i s e a s e s .  Although  a p p r o x i m a t e l y 80% o f o l d e r i n d i v i d u a l s a r e capable of independent l i v i n g , health condition  3 out o f every 4 have a t l e a s t one c h r o n i c  ( M i n i s t r y o f Supply & S e r v i c e s , 1982). A f t e r  4  t h e y are widowed, many women l i v e on t h e i r own. Although they do so d e s p i t e c h r o n i c h e a l t h c o n d i t i o n s , t h e r e have been few attempts t o understand t h e impact o f these c o n d i t i o n s on t h e i r lives. L i m i t e d f i n a n c i a l resources two  e a s i l y recognized  and c h r o n i c h e a l t h problems a r e  f a c t o r s t h a t can p l a c e o l d e r women i n a  h i g h r i s k group. However, minimal a t t e n t i o n has been d i r e c t e d towards i d e n t i f y i n g how o l d e r women draw on t h e i r resources  inner  and s t r e n g t h s which i n t u r n enable them t o cope w i t h  their situations.  Therefore,  a r e s e a r c h study t h a t a l l o w s and  encourages o l d e r women t o share t h e i r experiences and perceptions  o f l i v i n g i n o l d age i s needed.  T h i s l a c k o f i n f o r m a t i o n about women over 70 i s of s e r i o u s concern t o t h e n u r s i n g p r o f e s s i o n . In many areas o f p r a c t i c e , the c o n t a c t nurses have w i t h o l d e r women, w i l l o n l y i n c r e a s e . As consumers, o l d e r women expect nurses t o know about t h e i r  health  c a r e needs and use t h i s knowledge as a b a s i s f o r p r o v i d i n g a s s i s t a n c e . However, nurses who do n o t have an adequate u n d e r s t a n d i n g o f t h e o l d e r woman's p e r s p e c t i v e cannot  provide  q u a l i t y a s s i s t a n c e . Nurses may unknowingly s e t g o a l s which a r e either  t o o h i g h o r t h a t have no r e l e v a n c e  Conversely, previous  f o r o l d e r women.  i f nurses base t h e i r approach t o care on t h e i r  c o n t a c t w i t h v e r y d e b i l i t a t e d o l d e r people and b e l i e v e  t h i s t o be t h e norm, then goals may a u t o m a t i c a l l y be s e t t o o low f o r o t h e r o l d e r women. An o l d e r woman may be l o a t h t o r a i s e t h e g o a l l e v e l as she may f e e l t h e nurse i s t h e e x p e r t .  Therefore,  as t h e p o p u l a t i o n o f aging women i s i n c r e a s i n g , i t i s i m p e r a t i v e  5  for  t h e n u r s i n g p r o f e s s i o n t o c a r r y out r e s e a r c h t h a t w i l l  i n c r e a s e t h e knowledge base o f how women p e r c e i v e l i v i n g i n o l d age. Conceptual Framework The e x p e r i e n c e o f l i f e a f t e r 70 i s a broad t o p i c . Thus, i t i s important t o have an o r g a n i z i n g framework t h a t w i l l be a p p r o p r i a t e f o r t h i s age group, be f l e x i b l e enough t o i n c o r p o r a t e t h e uniqueness  of each woman's e x p e r i e n c e , and s t i l l  encourage i d e n t i f i c a t i o n o f shared phenomena. The concept o f " c r i t i c a l p e r i o d " i n t h e UBC model f o r n u r s i n g (1987) i s seen as capable o f meeting these requirements  and thus i s used f o r t h i s  study. A c c o r d i n g t o t h e UBC model f o r n u r s i n g (1987), a c r i t i c a l p e r i o d i s an event o c c u r r i n g d u r i n g t h e i n d i v i d u a l ' s l i f e which r e q u i r e s t h a t i n d i v i d u a l t o develop and use s u i t a b l e c o p i n g b e h a v i o r s t o s a t i s f y b a s i c human needs, achieve s t a b i l i t y , and r e a c h o p t i m a l h e a l t h . There a r e two kinds of c r i t i c a l p e r i o d s : " m a t u r a t i o n a l events and u n p r e d i c t a b l e events"  (U.B.C. model f o r  n u r s i n g , 1987, p.40). T h i s study focusses p r i m a r i l y on maturational events. W i t h i n a c r i t i c a l p e r i o d a m a t u r a t i o n a l event i s a p r e d i c t a b l e change t h a t occurs i n an i n d i v i d u a l ' s l i f e . developmental  As a  stage, o l d age w i l l have a c o l l e c t i o n of these  p r e d i c t a b l e changes. They may i n c l u d e : "body change, g e o g r a p h i c a l change, i n t r a f a m i l i a l change, r o l e change, s o c i a l i n t e r a c t i o n change, and work and c a r e e r change" (UBC model f o r n u r s i n g , 1987, p.40).  6  By c o n t r a s t , an u n p r e d i c t a b l e event occurs w i t h l i t t l e o r no warning. Examples o f such unexpected events " c i r c u l a t o r y d i s o r d e r s , degenerative trauma" (UBC model f o r n u r s i n g , 1987,  o r changes a r e :  d i s e a s e s , s e p a r a t i o n , and p.40). S e v e r a l  u n p r e d i c t a b l e events a r e a s s o c i a t e d w i t h o l d age. The model f u r t h e r suggests  t h a t a l l events  o r changes  a s s o c i a t e d w i t h t h e c r i t i c a l p e r i o d have a s s o c i a t e d l o s s e s and g a i n s which a r e understood  on an i n d i v i d u a l b a s i s . In g e n e r a l ,  d u r i n g a c r i t i c a l p e r i o d an i n d i v i d u a l may p e r c e i v e a l o s s o r a g a i n o f "a v a l u e d person,  some aspect o f s e l f , p o s s e s s i o n s , o r  p r i v i l e g e s w i t h i n t h e i r s o c i a l context" 1987,  (UBC model f o r n u r s i n g ,  p.41). As i n each developmental phase o f l i f e ,  o l d age  i n v o l v e s i t s own c h a r a c t e r i s t i c l o s s e s and g a i n s . F i n a l l y , the model c o n s i d e r s e x p e c t a t i o n s t o be a component of  a m a t u r a t i o n a l event. An e x p e c t a t i o n i s : " a n t i c i p a t e d , hoped  for,  o r p e r c e i v e d as r e q u i r e d . ... Some e x p e c t a t i o n s a r e  p e r s o n a l l y d e r i v e d , s o c i a l l y determined, and c u l t u r a l l y dictated"  (UBC model f o r n u r s i n g , 1987, p. 41). T h e r e f o r e , i t  f o l l o w s t h a t o l d e r women have e x p e c t a t i o n s about m a t u r a t i o n a l events  a s s o c i a t e d w i t h aging. More i n f o r m a t i o n i s needed about  the m a t u r a t i o n a l and u n p r e d i c t a b l e events d e s c r i p t i o n s o f changes o r events  i n o l d age. Women's  t h a t a f f e c t them and t h e i r  responses t o these events w i l l h e l p us t o understand experience  their  o f b e i n g over 70.  In summary, t h i s framework p r o v i d e s a way o f c o n c e p t u a l i z i n g t h e developmental stage o f o l d age as i n c l u d i n g a number o f a s s o c i a t e d changes. Each change has a s s o c i a t e d  7 l o s s e s and g a i n s . M a t u r a t i o n a l events a r e shaped by i n d i v i d u a l e x p e c t a t i o n s . Because t h e l o s s e s , g a i n s , and e x p e c t a t i o n s a r e u n i q u e l y p e r c e i v e d , the way t o understand  them i s t o e x p l o r e  t h e i r meaning w i t h t h e i n d i v i d u a l s who a r e e x p e r i e n c i n g t h e events o f t h e c r i t i c a l p e r i o d . Problem Statement As t h e number o f o l d e r women i n c r e a s e s , nurses w i l l be coming i n t o c o n t a c t w i t h them more f r e q u e n t l y . A t p r e s e n t t h e r e is  l i m i t e d i n f o r m a t i o n about the p e r c e p t i o n s o f o l d e r women  r e g a r d i n g t h e i r experiences of l i f e a t age 70 and o l d e r . Without it,  nurses w i l l not have t h e understanding  and knowledge  n e c e s s a r y t o adequately a s s i s t o l d e r women a t t a i n t h e i r d e s i r e d l e v e l of health. Purpose The purpose o f t h i s study i s t o e x p l o r e and t o d e s c r i b e how women who a r e e n c u l t u r a t e d i n t o Canadian s o c i e t y e x p e r i e n c e  life  a f t e r 70. The s p e c i f i c q u e s t i o n s t h a t d i r e c t e d t h e study a r e : 1. How do women d e s c r i b e t h e gains o r p o s i t i v e a s p e c t s a s s o c i a t e d w i t h t h i s stage of t h e i r  life?  2. How do women d e s c r i b e t h e l o s s e s o r n e g a t i v e a s p e c t s a s s o c i a t e d w i t h t h i s stage o f t h e i r  life?  3. How do women's a c t u a l experiences of b e i n g 70 and over compare w i t h t h e i r e a r l i e r e x p e c t a t i o n s of themselves stage o f t h e i r  at this  life? Methodology  A number o f f a c t o r s were c o n s i d e r e d i n choosing a methodology. F i r s t ,  l i t t l e i s known about t h e l i v e s o f women who  8 are 70 and over. As our knowledge i s l i m i t e d , i t i s t o o e a r l y t o i s o l a t e c e r t a i n f a c t o r s o r reduce women's l i v e s i n t o q u a l i t a t i v e u n i t s . Second, as E i c h l e r  (1980) p o i n t e d out, i t i s important t o  choose a methodology t h a t i s not s e x i s t . T h i r d , much o f t h e e x t a n t r e s e a r c h i n v o l v i n g o l d e r people has been done by younger researchers  from t h e i r younger p e r s p e c t i v e s . T h e r e f o r e t h e  chosen methodology must a l l o w women's p e r c e p t i o n s , b e l i e f s and experiences  t o u n f o l d without  t h e younger r e s e a r c h e r ' s b i a s o r  d i r e c t i o n . Given t h e above requirements,  phenomenology, a type  of q u a l i t a t i v e r e s e a r c h , i s t h e methodology o f c h o i c e . A d e s c r i p t i o n o f t h e methodology and i t s a p p l i c a t i o n t o t h e study w i l l be o u t l i n e d i n chapter  three.  Definitions C r i t i c a l p e r i o d : An event o c c u r r i n g d u r i n g an i n d i v i d u a l ' s l i f e t h a t r e q u i r e s t h e i n d i v i d u a l t o develop and use s u i t a b l e coping behaviors.  The two types of events a r e m a t u r a t i o n a l  u n p r e d i c t a b l e events.  changes and  (UBC model f o r n u r s i n g , 1987, p.40).  E n c u l t u r a t i o n : The process whereby i n d i v i d u a l s a r e c o n d i t i o n e d by,  a d j u s t e d t o , and i n t e g r a t e d w i t h t h e c u l t u r a l norms o f t h e i r  society Gain:  (Funk & Wagnalls, 1989, p.435).  "Having t h a t which i s o r can be of v a l u e "  (UBC model f o r  n u r s i n g , 1987, p.41). Growing o l d : F o r t h e purpose of t h i s study, growing o l d r e p r e s e n t s a dynamic s t a t e of being i n t h e l a t e r p o r t i o n o f t h e life  cycle.  Health:  "Health  object of l i v i n g .  ... i s a resource  f o r everyday l i f e ,  not the  H e a l t h i s a p o s i t i v e concept emphasizing  9 s o c i a l and p e r s o n a l r e s o u r c e s , as w e l l as p h y s i c a l  capacities"  (Ottawa, C h a r t e r , 1986, p. 426). L o s s : "Being without t h a t which has o r c o u l d have meaning f o r an individual" Old  Age:  (UBC model f o r n u r s i n g , 1987, p. 4 1 ) .  F o r t h e purpose o f t h i s study o l d age begins a t t h e  c h r o n o l o g i c a l age o f 65. M a t u r a t i o n a l Event:  "Changes t h a t occur w i t h  d u r i n g an i n d i v i d u a l ' s l i f e "  predictability  (UBC model f o r n u r s i n g , 1987,  p.40). U n p r e d i c t a b l e events: warning"  "Changes t h a t occur w i t h l i t t l e  o r no  (UBC model f o r n u r s i n g , 1987, p.40). Assumptions  There a r e a number of assumptions i n h e r e n t i n t h i s  study.  F i r s t , i t i s assumed t h a t women experience both g a i n s and l o s s e s in  t h e m a t u r a t i o n a l events and u n p r e d i c t a b l e events a s s o c i a t e d  w i t h o l d age. Second, women w i l l have had c e r t a i n e x p e c t a t i o n s about growing o l d e r . T h i r d , women who a r e c u r r e n t l y l i v i n g  alone  have d i f f e r e n t experiences from those who a r e l i v i n g w i t h a p a r t n e r o r i n an i n s t i t u t i o n . F i n a l l y , i t i s assumed t h a t t h e women a r e w i l l i n g and a b l e t o t a l k openly and h o n e s t l y , thereby g i v i n g an a c c u r a t e account of t h e i r p e r c e p t i o n o f r e a l i t y . Limitations Informants  i n t h e study are women who l i v e a l o n e . They were  s e l e c t e d from a s p e c i f i c m e t r o p o l i t a n area and from a s i m i l a r c u l t u r a l group. The amount of data c o l l e c t e d was l i m i t e d by time and r e s o u r c e s and thus, t h e c o n c l u s i o n s of t h e study's  findings  a r e l i m i t e d t o t h e informants i n t h i s study. Furthermore, t h e  10 e x p e r i e n c e s o f these women may not be t h e same as those i n f u t u r e g e n e r a t i o n s o f o l d e r women. Organization of the Thesis The subsequent  chapters d e s c r i b e both t h e process i n v o l v e d  i n answering t h e r e s e a r c h q u e s t i o n s , and an i n t e r p r e t a t i o n of the r e s u l t s . Chapter two p r e s e n t s l i t e r a t u r e t h a t i s p e r t i n e n t t o t h e r e s e a r c h problem.  Chapter t h r e e d e s c r i b e s and e x p l a i n s  the implementation o f t h e methodology adopted f o r t h i s  study.  The p a r t i c i p a n t s ' accounts and f i n d i n g s a r e p r e s e n t e d i n chapter f o u r . The f i n d i n g s a r e then viewed i n l i g h t o f r e l e v a n t l i t e r a t u r e i n Chapter f i v e . Chapter s i x concludes t h e study by summarizing  t h e f i n d i n g s and o u t l i n i n g t h e i m p l i c a t i o n s f o r  n u r s i n g p r a c t i c e , r e s e a r c h , and e d u c a t i o n . Summary Chapter one h i g h l i g h t s t h e l a c k o f i n f o r m a t i o n about women over 70 and o u t l i n e s t h e reasons why more r e s e a r c h i s needed. I t a l s o d e s c r i b e s t h e c o n c e p t u a l framework from t h e UBC model of nursing  (1987), which was used as a guide f o r t h i s study. The  c h a p t e r a l s o d e f i n e s s i g n i f i c a n t terms, and s t a t e s some l i m i t a t i o n s . Chapter two reviews l i t e r a t u r e t h a t i s p e r t i n e n t t o the r e s e a r c h problem.  11 CHAPTER 2 LITERATURE REVIEW  Introduction The purpose of t h e l i t e r a t u r e review i s t w o f o l d . F i r s t , from t h e d e s c r i p t i v e r e s e a r c h and l i t e r a t u r e , a p r o f i l e o f women who a r e now over 70 emerges. Second, t h e review  uncovers  r e l e v a n t i n f o r m a t i o n t h a t c o n t r i b u t e s t o our u n d e r s t a n d i n g o f l i f e f o r women who a r e now over 70. Three bodies o f l i t e r a t u r e and r e s e a r c h a r e o u t l i n e d i n t h e second s e c t i o n . They a r e : t h e p s y c h o s o c i a l t h e o r i e s on aging, r e s e a r c h s t u d i e s s p e c i f i c t o o l d e r women, and f i n a l l y g e n e r a l r e s e a r c h s t u d i e s which address the e x p e r i e n c e o f l i f e i n o l d age. P r o f i l e o f Women 70 and Over Women who a r e over 70 belong t o what i s termed a s p e c i f i c c o h o r t group. A c o h o r t may be d e f i n e d as "the aggregate o f individuals  ( w i t h i n some p o p u l a t i o n d e f i n i t i o n ) who e x p e r i e n c e  the same events w i t h i n t h e same time i n t e r v a l . Each c o h o r t has a d i s t i n c t i v e composition and c h a r a c t e r r e f l e c t i n g t h e c i r c u m s t a n c e s o f i t s unique o r i g i n a t i o n and h i s t o r y " 1985,  (Ryder,  p. 1 2 ) . Women who a r e now over 70 l i v e d through t h e d e p r e s s i o n o f  the 1930's and two world wars. They witnessed g r e a t advances i n t e c h n o l o g y . As young women, t h e i r r o l e s and l i f e s t y l e s were l e s s f l e x i b l e than women born i n l a t e r decades. They g e n e r a l l y m a r r i e d , had c h i l d r e n , and then stayed home t o r a i s e t h e c h i l d r e n . F o r t h e most p a r t they were dependent on t h e i r  12 husbands f o r t h e i r socioeconomic s t a t u s  (Maxwell, 1988). They  expected m a r i t a l s t a b i l i t y and aimed f o r f i n a n c i a l s e c u r i t y , home ownership and a b e t t e r l i f e f o r t h e i r c h i l d r e n (Baker, 1987). Choosing a c a r e e r and o p t i n g f o r s i n g l e l i f e was r a r e (Maxwell, 1988). Demographic data p r o v i d e i n f o r m a t i o n on t h i s present  cohort's  s t a t u s . In 1982, 78% of unattached women over 65 l i v e d  near o r below the poverty  line  (Gee & K i m b a l l ,  1987). In  g e n e r a l , as o l d e r women a r e l i v i n g l o n g e r and as t h e y have married  men o l d e r than themselves, they a r e f o u r times more  l i k e l y than men t o become widowed (Gee & K i m b a l l , women f r e q u e n t l y experience  1987).  Older  a t l e a s t one major h e a l t h problem.  These problems can i n c l u d e h e a r t d i s e a s e , cancer, d i s e a s e , o s t e o p o r o s i s , and d e p r e s s i o n .  Alzheimer's  They have a h i g h e r  i n c i d e n c e o f d i a b e t e s m e l l i t u s than men. They can a l s o s u f f e r from a v i s u a l o r h e a r i n g  impairment  (Gee & K i m b a l l ,  1987, Doress  & S i e g a l , 1987). Although we have a number o f f a c t s about o l d e r women, t h e p r o f i l e i s incomplete; few s t u d i e s examine how t h e o l d e r woman h e r s e l f f e e l s about h e r l i v i n g s i t u a t i o n . In an attempt t o o b t a i n a more complete p r o f i l e , t h e r e s e a r c h e r examined f o u r p s y c h o s o c i a l t h e o r i e s o f aging. P s y c h o s o c i a l Theories The  of Aging  f o u r p s y c h o s o c i a l t h e o r i e s of aging a r e t h e a c t i v i t y ,  disengagement, c o n t i n u i t y , and socio-environmental  theories.  These t h e o r i e s a r e f r e q u e n t l y c i t e d i n t h e l i t e r a t u r e about aging.  The work of Cavan, Burgess, Havighurst and Goldman (1949) and H a v i g h u r s t and A l b r e c h t (1953) i s c r e d i t e d w i t h c r e a t i n g the f o u n d a t i o n s of the a c t i v i t y t h e o r y (Gubrium, 1973). The g o a l of the Cavan e t a l . ,  study (1953) was  t o d e f i n e and a n a l y z e the  n a t u r e , p a t t e r n and problems of p e r s o n a l adjustment  to aging.  The study found t h a t two main f a c t o r s i n f l u e n c e d the  person's  a b i l i t y t o a d j u s t t o o l d age: p r e v i o u s p e r s o n a l i t y and levels.  Adjustment was  determined  t o be d i f f i c u l t  activity  because  " o l d e r people no l o n g e r occupied a r e s p e c t e d p o s i t i o n , had  no  r e c o g n i z e d f u n c t i o n and no s a n c t i o n e d p a t t e r n of a c t i v i t y " (Cavan e t a l . ,  1953,  p.10). The r e s e a r c h e r s concluded t h a t a  person's p e r s o n a l i t y a f f e c t e d t h e i r adjustment, p e r s o n a l i t y remained  constant throughout  They f u r t h e r concluded t h a t people who  and  that  an i n d i v i d u a l ' s  maintained t h e i r  life. activity  l e v e l s were b e t t e r a d j u s t e d . In  the second study by Havighurst and A l b r e c h t (1953) the  r e s e a r c h e r s found t h a t the adjustment  and a c t i v i t y scores of the  p a r t i c i p a n t s were h i g h l y c o r r e l a t e d . They h y p o t h e s i z e d t h a t people who  are more m e n t a l l y , p h y s i c a l l y , and s o c i a l l y  active  are b e t t e r adjusted. These s t u d i e s were a b e g i n n i n g s t e p towards the u n d e r s t a n d i n g t h a t some o l d e r people enjoy a wide v a r i e t y of a c t i v i t i e s a f t e r r e t i r e m e n t , and do i n f a c t enjoy l i f e  i n old  age. However, these s t u d i e s seemed t o imply t h a t a l l people must be a c t i v e t o be happy. The next t h e o r y i s the disengagement t h e o r y which i s based on a study by Cumming and Henry (1961). Cumming and Henry  14 e x p l a i n e d how young and o l d people d i f f e r i n t h e i r with l i f e .  involvement  They concluded t h a t o l d e r people disengage from  life.  They s t a t e d : "Aging i s an i n e v i t a b l e , mutual withdrawal o r disengagement, r e s u l t i n g i n decreased i n t e r a c t i o n between t h e a g i n g person and o t h e r s i n t h e s o c i a l system he belongs t o . When t h e a g i n g p r o c e s s i s complete, t h e e q u i l i b r i u m which e x i s t e d i n middle l i f e between t h e i n d i v i d u a l and h i s s o c i e t y has g i v e n way t o a new e q u i l i b r i u m c h a r a c t e r i z e d by g r e a t e r d i s t a n c e and a l t e r e d type o f r e l a t i o n s h i p " (p.15). T h e i r study i m p l i e d t h a t a l l o l d e r people n a t u r a l l y withdraw from s o c i e t y as they age, but t h e study d i d n o t e x p l a i n why some o l d e r people disengage more than o t h e r s . F i n a l l y , t h e r e was a f a i l u r e t o i d e n t i f y f a c t o r s t h a t may cause an extreme disengagement p r o c e s s . The t h i r d t h e o r y , t h e c o n t i n u i t y t h e o r y , e v o l v e d from a study by Neugarten,  Havighurst and Tobin (1963). They concluded  t h a t p e r s o n a l i t y f a c t o r s were t h e important v a r i a b l e s i n a d j u s t i n g t o o l d age because n e i t h e r t h e a c t i v i t y n o r disengagement t h e o r i e s c o u l d adequately e x p l a i n t h e r e s u l t s  from  t h e i r study. T h e i r f i n d i n g s showed a h i g h c o r r e l a t i o n between s o c i a l i n t e r a c t i o n and s o c i a l w e l l - b e i n g , although they a l s o found t h a t some o l d e r people had a low s o c i a l a c t i v i t y r o l e and yet  were h i g h l y s a t i s f i e d w i t h  life.  By examining p a t t e r n s o f aging, Neugarten  et al.,  (1963)  were a b l e t o i d e n t i f y f o u r p e r s o n a l i t y p a t t e r n s : i n t e g r a t e d , armoured o r defended, passive-dependent study suggested t h a t  and u n i n t e g r a t e d . T h i s  " i n normal men and women t h e r e i s no sharp  d i s c o n t i n u i t y of p e r s o n a l i t y w i t h age but i n s t e a d i n c r e a s e d continuity"  (Neugarten e t a l . ,  1963, p.177). Thus we can i n f e r  15 from t h i s study t h a t men and women w i l l not suddenly change as they grow o l d e r . The  f i n a l study i s l a b e l l e d t h e s o c i o - e n v i r o n m e n t a l  The study was c o n s t r u c t e d t o understand  theory.  the s o c i a l behaviors of  the aged (Gubrium, 1973). The s o c i o - e n v i r o n m e n t a l  theory  encouraged s o c i e t y t o view o l d e r i n d i v i d u a l s n o t i n i s o l a t i o n , but w i t h i n t h e c o n t e x t o f t h e i r  environments.  Gubrium (1973) b e l i e v e d t h a t t h e a c t i v i t y and disengagement t h e o r i e s were u s e f u l i n l i m i t e d circumstances but were n o t c o n c e p t u a l l y l i n k e d . He c o n c e p t u a l i z e d t h e environment s u r r o u n d i n g o l d e r people as having both a s o c i a l and i n d i v i d u a l c o n t e x t . The s o c i a l context i n c l u d e d a c t i v i t y norms and c e r t a i n b e h a v i o r a l e x p e c t a t i o n s from s o c i e t y . On t h e o t h e r hand, t h e i n d i v i d u a l c o n t e x t i n c l u d e d a c t i v i t y r e s o u r c e s which c o n s i s t e d of s t a t e o f h e a l t h , f i n a n c i a l s o l v e n c y and t h e s t a t e of s o c i a l support. I f a person had many a c t i v i t y r e s o u r c e s t h e i r  behaviors  c o u l d be much more f l e x i b l e . Gubrium (1973) f u r t h e r proposed  t h a t both t h e s o c i a l and  i n d i v i d u a l components of an i n d i v i d u a l ' s environment had an impact  on a person's morale. Morale was based on how persons  judged themselves  and t h e i r a t t i t u d e s towards themselves. The  judgements were i n t u r n a f f e c t e d by t h e s o c i a l and i n d i v i d u a l c o n t e x t s . I f t h e i n d i v i d u a l f e l t t h a t s o c i e t y expected  a certain  type o f behaviour, but they d i d n o t have t h e a c t i v i t y r e s o u r c e s a v a i l a b l e t o perform t h e b e h a v i o r s , then t h e i r morale would be lowered.  T h e r e f o r e Gubrium (1973) concluded t h a t i t was  i m p o s s i b l e t o determine  how people f e l t  j u s t by o b s e r v i n g t h e i r  16 activity  alone.  environment The  I t was n e c e s s a r y  i n which  above  that  on d i f f e r e n t  studies  been  for their  inability  of other  (Burbank,  studies  fail  t o provide  more  into  Information specific  a clear,  of the aging  The g e n e r a l  as they  research  a 1  literature  health  research  review  6year  results  Furthermore, bias  these  from t h e  i n the research,  p e r t a i n t o women b e c o m e t o provide  even  any s p e c i f i c 70. i n the  promotion  from  aging  issues  support  a r e summarized  1 9 6 9 found She found  very  (1986)  little  n e i t h e r r e s e a r c h on  nor studies that  looked  a t health  f o r o l d e r women. T h e n u r s i n g  on disease  as t h e three  o n Women  o n o l d e r women b y R o b i n s o n  period  ( 1 9 8 6 ) identified retirement  i n their  and h o l i s t i c  o f women who a r e o v e r  o n women a n d a g i n g .  focussed  the studies  o n women a n d a g i n g .  women's a t t i t u d e s t o w a r d and  defined  and f o r t h e  p e r t i n e n t t o o l d e r women c a n b e f o u n d  literature  spanning  research  1 9 5 4 ) . In general  theories f a i l  the perceptions more  These  comprehensive  process.  Research A  to replicate  i n f o r m a t i o n d e s c r i b i n g t h e male  suspect.  varying  lack of clearly  1 9 8 6 ; Katren,  findings of the studies  insight  place.  of aging.  for their  researchers  form  the  took  the context o r  i n c o n s i s t e n t use o f terms  present  previous  aspects  criticized  concepts,  understanding  activity  studies and t h e o r i e s provide  perspectives have  to consider  and i n s t i t u t i o n a l i z a t i o n . networks,  main below.  subject  Robinson  c a r e g i v i n g r e l a t i o n s h i p s and areas  i n t h e r e s e a r c h . The  17 In t h e s o c i a l support  network l i t e r a t u r e , Robinson (1986)  found t h a t both l i f e s a t i s f a c t i o n were s t r o n g l y r e l a t e d relationships. well-being  and p s y c h o l o g i c a l  t o women's s a t i s f a c t i o n  Widowed c h i l d l e s s  with  well-being intimate  women had a lower sense o f  than widowed mothers.  In t h e c a r e g i v i n g l i t e r a t u r e , Robinson (1986) i d e n t i f i e d the two d i f f i c u l t i e s most o f t e n c i t e d by o l d e r women who were c a r i n g f o r a spouse o r f a m i l y member as l a c k o f f i n a n c e s and s o c i a l i s o l a t i o n . T h i s l i t e r a t u r e a l s o examined t h e b e n e f i c i a l aspects  of supportive  c o u n s e l l i n g and support  groups f o r o l d e r  c a r e g i v i n g women. Robinson's (1986) review of t h e l i t e r a t u r e on r e t i r e m e n t f o r women p o i n t e d out t h a t , i n g e n e r a l , women were h a p p i e r men  with the retirement  may  be p a r t l y  related  than  phase of t h e i r l i v e s . T h i s adjustment  t o t h e f a c t t h a t many women l e f t t h e work  f o r c e a number o f times ( i f they were i n i t a t a l l ) t o r a i s e their children.  As a r e s u l t ,  a d j u s t t o many d i f f e r e n t  situations  (1986) t h r e e s u b j e c t areas, retirement  they had g r a d u a l l y l e a r n e d t o over t h e y e a r s .  s o c i a l support,  a r e important but s t i l l p r o v i d e  i n f o r m a t i o n on t h e l i v e s and experiences  Robinson's  c a r e g i v i n g , and insufficient  of women who a r e over  70. Next, t h e r e s e a r c h on widows i s examined f o r r e l e v a n t  data  on o l d e r women. Harvey e t a l . , (1987) s t u d i e d widowhood i n Canada. In t h e i r a r t i c l e , they f i r s t  summarized t h e r e s e a r c h  f i n d i n g s from  widowhood s t u d i e s t h a t were performed i n t h e U n i t e d Canada, Europe and B r i t a i n . Then, they presented  other  States,  t h e i r own  18 r e s e a r c h f i n d i n g s . From the e x i s t i n g l i t e r a t u r e , t h e y found t h a t people w i t h adequate  incomes, who  were h e a l t h y , r e l a t i v e l y w e l l  educated, and had a c l o s e c o n f i d a n t , coped b e t t e r w i t h widowhood than people who  were poor, uneducated  and unhealthy. F o r some  women, widowhood c r e a t e d a s i t u a t i o n whereby they became aware of t h e i r own  personal strengths.  The morale of some widows was and income. Women who  a f f e c t e d by a c t i v i t y  were i n v o l v e d w i t h more a c t i v i t i e s had a  h i g h e r morale. Some women s u f f e r e d from a lowered morale of t h e i r reduced incomes r a t h e r than because marital  levels  because  of t h e i r change i n  status.  The data f o r the Harvey e t al.,(1987) study were drawn from the data i n the 1978  Canada H e a l t h Survey. They found t h a t  m a r r i e d people i n g e n e r a l had a h i g h e r morale than widowed p e o p l e . Income d i d not show a s t r o n g independent morale. On the o t h e r hand, good h e a l t h was  effect  positively  on  correlated  w i t h morale. The r e s e a r c h e r s a l s o found t h a t l i v i n g a l o n e d i d not have a d e t r i m e n t a l e f f e c t on mood. U n f o r t u n a t e l y , the data d i d not i n d i c a t e how  l o n g the people had been widowed, which  c o u l d be an important v a r i a b l e f o r study. Although t h i s does h e l p us t o understand f a c t o r s t h a t may  study  a f f e c t a woman's  a b i l i t y t o cope w i t h widowhood, her p e r s p e c t i v e s on b e i n g a widow remain unknown. An ethnographic study by Matthews (1979) i d e n t i f i e d  the  s t r a t e g i e s o l d e r women used t o m a i n t a i n t h e i r s e l f i d e n t i t y i n what Matthews determined t o be a s e x i s t and a g e i s t s o c i e t y . r e s e a r c h e r concluded t h a t women r e l i e d upon compliance,  The  avoidance,  r e c i p r o c i t y , m o n i t o r i n g warning s i g n a l s and  c o n t i n u i t y . Women who had l i t t l e power and few r e s o u r c e s t o o f f e r as exchange i n a r e l a t i o n s h i p o f t e n turned t o compliance. Avoidance  was used t o prevent p o t e n t i a l l y  embarrassing  s i t u a t i o n s . R e c i p r o c i t y o r being busy and doing t h i n g s f o r o t h e r people helped them t o m a i n t a i n t h e i r s e l f i d e n t i t y . The women monitored  t h e i r h e a l t h t o h e l p prevent a l o n g and l i n g e r i n g  death. C o n t i n u i t y , t h e f i n a l s t r a t e g y , was d e s c r i b e d as s t a y i n g in  f a m i l i a r surroundings w i t h people t h a t they knew. in  for of  g e n e r a l Matthews' study h e l p s us t o understand  t h e need  c o n t i n u i t y i n o l d e r women's l i v e s , e s p e c i a l l y i n t h e areas r e l a t i o n s h i p s , a c t i v i t i e s and i d e n t i f i c a t i o n w i t h a home area  ( F e n n e l l , P i l l i p s o n & Evers, 1988 p.105). However, an understanding  of how women p e r c e i v e l i v i n g i n o l d age s t i l l  remains e l u s i v e . F o r t u n a t e l y , w i t h t h e c u r r e n t i n t e r e s t i n l o n g e v i t y , r e c e n t s t u d i e s have been completed  which p r o v i d e  i n s i g h t i n t o the aging process. This general research i s described  next. Recent Information on Aging  Over t h e p a s t decade, a number of q u a l i t a t i v e r e s e a r c h s t u d i e s have p r o v i d e d i n s i g h t i n t o how o l d e r people old  age.  experience  F o r example, a grounded study by Kaufman (1986) showed  t h a t o l d e r people's i d e n t i t i e s were not d e f i n e d by t h e i r age. O l d e r i n d i v i d u a l s d i d not see themselves  as o l d , but r a t h e r as  b e i n g i n t h e p e r i o d o f o l d age. Kaufman (1986) f u r t h e r concluded t h a t l i f e was n o t a t r a j e c t o r y o f r i s e and then  20 d e c l i n e i n o l d age, but was all  a continuous process w i t h meaning a t  stages. Other s t u d i e s show the importance  P r e v i o u s l y , o l d e r people who i n the p a s t , which was Now  i t i s understood  of r e m i n i s c i n g i n a g i n g .  r e m i n i s c e d were p o r t r a y e d as  equated w i t h unhealthy mental  living  behaviour.  t h a t r e m i n i s c i n g o r r e c a l l i n g the p a s t i s a  normal and h e a l t h y way  of making sense of and p u t t i n g t h e i r  l i v e s i n o r d e r (Breystpraak, 1984,  Burdman, 1986).  The common image of a l l o l d people being  forgetful,  confused, and s e n i l e i s no l o n g e r a u t o m a t i c a l l y accepted as a normal s t a t e . A c l o s e r unbiased examination  of o l d e r people  showed t h a t d e p r e s s i o n , e x c e s s i v e m e d i c a t i o n , and m a l n u t r i t i o n c o u l d cause c o n f u s i o n ( G r i f f i t h Kenney, 1986). T h e r e f o r e , c o n f u s i o n i s not normal and warrants  investigation.  Many younger people assume t h a t o l d e r people are not v e r y happy. D e p r e s s i o n was  c i t e d as a problem f o r women (Gee &  K i m b a l l , 1987). However t h i s does not mean t h a t a l l o l d e r women are depressed. A Canadian study by C o n n i d i s (1987) found t h a t t h e r e a r e both p o s i t i v e and n e g a t i v e aspects of a g i n g f o r people over 65. Her study found t h a t 90% of her sample l i k e d  something  about t h e i r age, w h i l e o n l y 10% of the sample claimed t h a t they d i d not l i k e a n y t h i n g about t h e i r age.  In a d d i t i o n , 34%  found  n o t h i n g t o d i s l i k e about t h e i r age. Areas of l i k e s i n c l u d e d g r e a t e r freedom and fewer w o r r i e s . However, common d i s l i k e s i n c l u d e d e f f e c t s c r e a t e d by d e c l i n i n g p h y s i c a l f u n c t i o n s and poor h e a l t h .  T h e r e f o r e , we  can assume t h e r e are some p o s i t i v e  a s p e c t s about b e i n g over 70 but t h e r e are a l s o some concerns.  21 A Vancouver study i n 1985 p r o v i d e d  i n s i g h t i n t o how men and  women over 65 p e r c e i v e h e a l t h . S t a t i s t i c s show t h a t many o l d e r people s u f f e r from a t l e a s t one c h r o n i c d i s e a s e .  This  phenomenological study on w e l l s e n i o r s ' p e r c e p t i o n s  of health  demonstrated t h a t they do not view h e a l t h as simply  freedom from  illness  (Thorne, G r i f f i n & A d l e r s b e r g ,  i n t h e study experienced discomfort,  1985). The p a r t i c i p a n t s  chronic i l l n e s s e s , p h y s i c a l  and movement l i m i t a t i o n s . However, t h e study showed  t h a t they experienced  h e a l t h on t h r e e l e v e l s o f awareness:  p h y s i c a l comfort and a b i l i t i e s , connectedness and competence, and  a sense o f meaning. T h i s study v a l i d a t e s t h e i d e a t h a t o l d e r  men  and women have unique p e r c e p t i o n s  o t h e r aspects  of t h e i r  about t h e i r h e a l t h and  lives.  These r e c e n t s t u d i e s p r o v i d e  some i n s i g h t i n t o t h e world of  the o l d e r person. They demonstrate t h a t when o l d e r p a r t i c i p a n t s are encouraged t o share t h e i r p e r c e p t i o n s ,  new and more  accurate  i n f o r m a t i o n can emerge. The f i n d i n g s from these s t u d i e s c h a l l e n g e many o f t h e t r a d i t i o n a l b e l i e f s about a g i n g . the knowledge s p e c i f i c t o t h e experiences  However,  and p e r c e p t i o n s o f  women over 70 remains l i m i t e d . Summary T h i s chapter research  has examined t h r e e bodies o f l i t e r a t u r e and  i n o r d e r t o d i s c o v e r more about women over 70. The  p s y c h o s o c i a l t h e o r i e s o f f e r l i m i t e d i n f o r m a t i o n . The r e s e a r c h s t u d i e s on o l d e r women p r o v i d e background on s o c i a l caregiving, retirement,  support,  strategies for protecting self  identity,  and widowhood. More r e c e n t s t u d i e s begin t o d e l v e i n t o t h e  p e r c e p t i o n s of o l d e r people and c h a l l e n g e many of the b e l i e f s about o l d age. Although the s t u d i e s are u s e f u l , they s t i l l not y i e l d a complete, h o l i s t i c understanding of how womert experience l i f e a f t e r  70.  do  23 CHAPTER 3 METHODOLOGY  Introduction Chapter t h r e e p r o v i d e s a broad overview of phenomenology, the r e s e a r c h methodology employed i n t h i s study. I t a l s o o u t l i n e s the s p e c i f i c d i r e c t i o n f o r informant s e l e c t i o n , data c o l l e c t i o n , and d a t a a n a l y s i s . F i n a l l y , i t p r e s e n t s the study's ethical considerations. Overview of Phenomenology Phenomenology i s an i n d u c t i v e , d e s c r i p t i v e r e s e a r c h approach  (Omery, 1983). I t s g o a l i s not t o v a l i d a t e p r e c o n c e i v e d  i d e a s o r e x p e c t a t i o n s (Omery, 1983). Rather, i t aims i s t o d e s c r i b e c e r t a i n human experiences as they are l i v e d understood.  ( G e o r g i , 1985;  O i l e r , 1986;  and  Parse, Coyne, & Smith,  1985). T h i s method enables the r e s e a r c h e r t o g a i n an u n d e r s t a n d i n g of how  those i n v o l v e d i n t e r p r e t and g i v e meaning  to a given s i t u a t i o n  ( R i s t , 1978). The data are d e l i b e r a t e l y  s u b j e c t i v e as o n l y the p a r t i c i p a n t s know what i s r e l e v a n t and important t o them. The r e s e a r c h e r ' s t a s k i s "to l e t the world of the d e s c r i b e r , o r more c o n c r e t e l y , the s i t u a t i o n as i t e x i s t s f o r the s u b j e c t s , r e v e a l i t s e l f i n an unbiased way description"  ( G i o r g i , 1975,  through  the  p. 74). The r e s e a r c h e r ' s knowledge  must be h e l d i n doubt. B i a s e s must be acknowledged. Only then can the r e s e a r c h e r take a f r e s h look a t the s u b j e c t so t h a t u n d e r s t a n d i n g can be reached  ( O i l e r , 1986;  Giorgi,  1985).  new  24 The study begins w i t h a s e r i e s of i n t e r v i e w s . The  account  u n f o l d s through the p a r t i c i p a n t ' s v e r b a l d e s c r i p t i o n s which are then a n a l y z e d . The r e s e a r c h e r must ensure throughout  the  i n t e r v i e w s , t h a t what he/she hears i s c o r r e c t . T h i s i s accomplished  by v a l i d a t i n g the data w i t h the p a r t i c i p a n t s  (Knaack, 1984). C r e d i b i l i t y and a u d i t a b i l i t y are the f a c t o r s which determine  the v a l i d i t y and r e l i a b i l i t y  of the n a r r a t i o n i n a  q u a l i t a t i v e study (Sandelowski, 1986). She a s s e r t s t h a t a study i s c r e d i b l e i f the informants v e r i f y the t r u t h of the f i n d i n g s . A study i s a u d i t a b l e whenever a l l the steps are c l e a r l y o u t l i n e d , the d a t a a n a l y s i s i s c l e a r l y a r t i c u l a t e d and i t i s e v i d e n t why  c e r t a i n c o n c l u s i o n s are drawn from the d a t a . G i o r g i  (1985) s t a t e s t h a t  "other r e s e a r c h e r s must be a b l e t o see what  the o r i g i n a l r e s e a r c h e r sees even i f they do not agree w i t h i t " (p.  96). A l s o , o t h e r s who  are e x p e r i e n c i n g s i m i l a r  circumstances  s h o u l d be a b l e t o c o n f i r m the f i n d i n g s i n the r e s e a r c h a n a l y s i s (Knaack, 1984). To o b t a i n the type of data needed f o r the study, phenomenology uses t h e o r e t i c a l sampling. A t h e o r e t i c a l sample i s s e l e c t e d a c c o r d i n g t o the t h e o r e t i c a l needs and d i r e c t i o n of the r e s e a r c h , and c o n s i s t s of i n d i v i d u a l s who t h e i r views c l e a r l y and who the r e s e a r c h (Morse,  are a b l e t o a r t i c u l a t e  are r e c e p t i v e t o b e i n g i n v o l v e d i n  1986). With t h i s overview of the  methodology, the next s e c t i o n d e s c r i b e s the process.  implementation  25 S e l e c t i o n of P a r t i c i p a n t s Following  t h e p r i n c i p l e s of t h e t h e o r e t i c a l sampling  t e c h n i q u e , t h e r e s e a r c h e r chose women who c o u l d p r o v i d e t h e most i n s i g h t f u l information  f o r the study. To guide t h i s s e l e c t i o n ,  s p e c i f i c c r i t e r i a were o u t l i n e d . C r i t e r i a for Selection The  c r i t e r i a f o r s e l e c t i n g the p a r t i c i p a n t s included the  following: 1. each woman was aged 70 o r over. 2. each woman l i v e d on h e r own i n t h e g e n e r a l community. 3. each woman was e n c u l t u r a t e d  i n t o Canadian s o c i e t y .  4. each woman was f l u e n t i n E n g l i s h . 5. each woman l i v e d i n t h e lower mainland. S e l e c t i o n Procedure The  p a r t i c i p a n t s were r e c r u i t e d d i r e c t l y through t h e  r e s e a r c h e r and through an i n f o r m a l a c q u a i n t a n c e s . I t was b e l i e v e d  network o f c o l l e a g u e s and  t h a t an i n f o r m a l  network  could  p r o v i d e a s e l e c t i o n o f s u i t a b l e p a r t i c i p a n t s l i v i n g on t h e i r own throughout t h e community. The r e s e a r c h e r c o n t a c t e d these colleagues and  and acquaintances, d e s c r i b e d  t h e purpose o f t h e study  o u t l i n e d t h e s e l e c t i o n c r i t e r i a . Those who knew of a  p o t e n t i a l p a r t i c i p a n t were g i v e n a l e t t e r o f i n f o r m a t i o n  and a  Consent t o Contact form (see Appendix A ) . They, i n t u r n ,  talked  to p o t e n t i a l p a r t i c i p a n t s , explained l e t t e r of information the consent t o c o n t a c t  t h e study, gave them t h e  and requested t h a t t h e woman e i t h e r form, o r contact  return  the researcher d i r e c t l y  by t e l e p h o n e . Seven o f t h e p a r t i c i p a n t s were o b t a i n e d t h i s way  26  and one was r e c r u i t e d d i r e c t l y by t h e r e s e a r c h e r . convenient arranged.  Mutually  times t o conduct i n t e r v i e w s i n t h e women's homes were A t t h e f i r s t home v i s i t ,  the researcher explained the  purpose o f t h e study, d i s c u s s e d what p a r t i c i p a t i o n would i n v o l v e and answered any q u e s t i o n s . The Consent t o P a r t i c i p a t e forms were then signed  (see Appendix B ) . A t o t a l of e i g h t women took  p a r t i n t h e study. C h a r a c t e r i s t i c s of the P a r t i c i p a n t s The  e i g h t women ranged i n age from 75 t o 88. S i x women  were born i n Vancouver, one i n O n t a r i o and one i n England. A l l were widows. The l e n g t h o f time they had been widowed v a r i e d from l e s s t h a t 1 year t o over 35 y e a r s . A l l o f t h e women were mothers. Two o f t h e p a r t i c i p a n t s had u n i v e r s i t y degrees. S i x had worked o u t s i d e t h e home i n v a r i o u s c a p a c i t i e s w h i l e two had been f u l l time homemakers. They a l l l i v e d i n p r i v a t e d w e l l i n g s , e i t h e r r e n t e d o r owned, and were w e l l e s t a b l i s h e d i n t h e i r neighborhoods. All  b u t one woman r e p o r t e d a t l e a s t one h e a l t h impairment.  These i n c l u d e d a r t h r i t i s , c a r d i o v a s c u l a r d i s e a s e s ,  impaired  v i s i o n and h e a r i n g . One woman had i n j u r i e s from an automobile a c c i d e n t . Three o f t h e women r e c e i v e d homemaker h e l p through t h e Long Term Care Program. Two of t h e women attended  an a d u l t day  c a r e program, t h r e e days a week. Data C o l l e c t i o n and A n a l y s i s Data c o l l e c t i o n and a n a l y s i s a r e d i s c u s s e d s e p a r a t e l y . However, d u r i n g t h e study, these two processes  ran concurrently;  the d a t a were analyzed throughout  the c o l l e c t i o n phase and  r e s u l t s of t h i s a n a l y s i s i n f l u e n c e d the ongoing data  the  collection  process. The  i n t e r v i e w s were s e m i - s t r u c t u r e d , the r e s e a r c h e r  open-ended q u e s t i o n s t o e l i c i t the p a r t i c i p a n t ' s views. r e s e a r c h e r ' s i n t e n t was p o s s i b l e without  asked The  t o o b t a i n as much i n f o r m a t i o n as  s t e e r i n g the p a r t i c i p a n t i n a  predetermined  d i r e c t i o n . The t h r e e t r i g g e r q u e s t i o n s used t o i n i t i a t e i n t e r v i e w s arose from the l i t e r a t u r e model f o r n u r s i n g (1987),  ( C o n n i d i s , 1987)  (see Appendix C ) . Although  the  and  UBC  the same  t r i g g e r q u e s t i o n s were asked of everyone, not a l l of the i n t e r v i e w s were i d e n t i c a l . In g e n e r a l , the r e s e a r c h e r f o l l o w e d the l e a d of the informant who r e s e a r c h e r . In t h i s way  i n t u r n responded t o the  each woman helped t o d i r e c t the d a t a  collection. The  f i r s t round of i n t e r v i e w s w i t h each s u b j e c t was  c o l l e c t g e n e r a l i n f o r m a t i o n . Between the f i r s t and  used t o  second  i n t e r v i e w s , the r e s e a r c h e r t r a n s c r i b e d each tape verbatim.  After  i n t e r v i e w i n g each woman once, the r e s e a r c h e r c o n s t r u c t e d a framework t o i d e n t i f y themes and r e l a t i o n s h i p s . T h i s framework guided the second i n t e r v i e w i n which the r e s e a r c h e r asked f o r c l a r i f i c a t i o n , v a l i d a t e d the emerging themes and o b t a i n e d more complete i n f o r m a t i o n about each woman's p e r c e p t i o n of b e i n g 70. Data c o l l e c t i o n continued u n t i l  "the data was  complete, without gaps, made sense and had been (Morse, 1986,  deemed confirmed"  p. 184). S i n c e the r e s e a r c h e r accomplished  c r i t e r i a upon the completion  over  these  of second i n t e r v i e w w i t h each  28 p a r t i c i p a n t , no f u r t h e r i n t e r v i e w s were conducted and no new s u b j e c t s were added t o t h e study. The  accounts  were c o n s t r u c t e d from t h e 15 i n t e r v i e w s which  l a s t e d between one and a h a l f t o two and a h a l f hours each. One of  t h e woman became i l l and was unable t o p a r t i c i p a t e i n t h e  second i n t e r v i e w . Data A n a l y s i s The  i n t e n t o f t h e data a n a l y s i s was t o understand  more  about how these women p e r c e i v e d t h e i r l i v e s . To g a i n t h i s understanding Giorgi  t h e data were analyzed u s i n g t h e steps o u t l i n e d by  (1975, 1985). The steps a r e summarized. A f t e r t h e tapes  from each i n t e r v i e w were t r a n s c r i b e d , t h e i n i t i a l  s t e p was f o r  the r e s e a r c h e r t o read each e n t i r e t r a n s c r i p t t o g e t a sense o f the whole o r t h e g e n e r a l p i c t u r e t h a t t h e woman was p r e s e n t i n g . Then b e f o r e t a k i n g t h e s p e c i f i c aim o f t h e study i n t o account and  i n a d v e r t e n t l y i n t e r p r e t i n g t h e accounts  i n a s p e c i f i c way,  the r e s e a r c h e r i d e n t i f i e d t h e n a t u r a l meaning u n i t s t h a t were presented  i n t h e accounts.  the accounts  The dominant themes which r a n through  were then i d e n t i f i e d . F i n a l l y , t h e d a t a were  examined w i t h t h e s p e c i f i c purpose o f t h e study i n mind. The q u e s t i o n was asked, what d i d each statement t e l l t h e r e s e a r c h e r about t h e experience  o f aging? Many s m a l l p i e c e s o f i n f o r m a t i o n  g r a d u a l l y f i t i n t o a l a r g e r d e s i g n which i n t u r n f i t i n t o an o v e r a l l s t r u c t u r e o r framework. T h i s f i n a l s t e p i s what G i o r g i d e s c r i b e d as t y i n g a l l t h e themes t o g e t h e r i n t o one nonredundant theme. The f i n a l s t r u c t u r e helped t o d e s c r i b e how t h i s  29 group of women p e r c e i v e d t h e i r l i v e s when they are over 70.  The  r e s u l t s of the data a n a l y s i s are d i s c u s s e d i n c h a p t e r f o u r .  E t h i c s and Human Rights The e t h i c a l and human r i g h t s of the s u b j e c t s were p r o t e c t e d i n the f o l l o w i n g ways: 1. The U n i v e r s i t y of B r i t i s h Columbia B e h a v i o r a l S c i e n c e s S c r e e n i n g Committee f o r Research and Other S t u d i e s I n v o l v i n g Human S u b j e c t s gave w r i t t e n approval t o c a r r y out the  study.  2. The p a r t i c i p a n t s had the o p t i o n of r e t u r n i n g a Consent t o Contact form, o r c o n t a c t i n g the r e s e a r c h e r d i r e c t l y f o r an interview. 4. The purpose of the study, the r o l e of the p a r t i c i p a n t s ,  the  type of data t o be c o l l e c t e d and what would happen t o the data were c l e a r l y o u t l i n e d f o r the s u b j e c t s . 5. The p a r t i c i p a n t s were informed t h a t they were f r e e t o withdraw from the study a t any time. They c o u l d r e f u s e t o answer any q u e s t i o n s , have the tape r e c o r d e r stopped, any p o r t i o n of the tape be  or request that  erased.  6. The p a r t i c i p a n t s were a d v i s e d t h a t t h e i r d e c i s i o n t o not p a r t i c i p a t e o r t o withdraw from the study would not t h e i r treatment  o r care i n any  jeopardize  way.  7. The p a r t i c i p a n t s were assured of c o n f i d e n t i a l i t y . The  taped  m a t e r i a l and t r a n s c r i p t s c o n t a i n e d no i d e n t i f y i n g f a c t o r s . A l l of the p a r t i c i p a n t s were g i v e n an i d e n t i t y code number which known o n l y t o the r e s e a r c h e r .  was  30 8. The tapes were t o be d e s t r o y e d o r erased a t t h e end of the study. 9. Consent t o P a r t i c i p a t e forms were s i g n e d by t h e p a r t i c i p a n t s p r i o r t o commencing the i n t e r v i e w s . These n i n e p r e c a u t i o n s helped t o ensure t h a t t h e e t h i c a l r i g h t s of t h e women were p r o t e c t e d . Summary Phenomenology was the r e s e a r c h methodology s e l e c t e d t o guide t h i s study. In c o n j u n c t i o n w i t h t h i s approach, p a r t i c i p a n t s who ranged  the e i g h t  i n age from 75 t o 88 were s e l e c t e d f o r  t h e i r a b i l i t y t o p r o v i d e a c c u r a t e and l u c i d accounts of l i f e over 70. Data were c o l l e c t e d through 15 i n - d e p t h i n t e r v i e w s . Data a n a l y s i s took p l a c e c o n c u r r e n t l y w i t h and subsequent t o the i n t e r v i e w s . The r e s u l t s of t h a t data a n a l y s i s a r e p r e s e n t e d i n chapter f o u r .  31 CHAPTER 4 RESEARCH FINDINGS  Introduction The  purpose o f Chapter Four i s t o r e p o r t t h e r e s e a r c h  f i n d i n g s . The e i g h t women i n t h i s r e s e a r c h study t o l d many s t o r i e s t h a t d e s c r i b e d v a r i o u s aspects of t h e i r l i v e s . From t h e i r , s t o r i e s , a number o f themes emerged. The r e s e a r c h e r s y n t h e s i z e d and i n t e g r a t e d these themes i n t o a framework c a l l e d "the c y c l e o f contentment" (see F i g u r e 1 o v e r l e a f ) . W i t h i n  this  c y c l e t h e r e a r e a number o f phases. In o r d e r t o understand t h e o v e r a l l c y c l e , t h e r e s e a r c h e r has d e s c r i b e d each phase i n detail. to  I t i s important  t o note t h a t these f i n d i n g s r e l a t e  t h e e i g h t women who p a r t i c i p a t e d i n t h e study.  Therefore,  r e f e r e n c e s t o "the women" r e f e r o n l y t o t h e women i n t h i s u n l e s s otherwise  only  study  stated. Contentment  One  of the f i r s t  themes t o emerge was contentment.  Contentment seemed t o be a s t a t e o f mind which these women p r e s e n t l y d e s i r e d . I t was l o o s e l y d e f i n e d as a form o f happiness c h a r a c t e r i z e d by calmness and freedom from uneasiness. The f o l l o w i n g quotes d e s c r i b e i n d i v i d u a l p a r t i c i p a n t s ' d e s i r e f o r contentment ( I . and R. i n d i c a t e I n t e r v i e w e r and Respondent respectively). R. I don't t h i n k happiness i s t h e end a l l f o r every stage o f l i f e and I t h i n k as you g e t o l d e r contentment i s the more important. I am v e r y contented w i t h my life.  Figure 1  The Cycle of Contentment EXPERIENCING THREATS - death of spouse - death of friends - health problems - attitudes of others  INDEPENDENCE & CONNECTEDNESS (Sources of Contentment)  CALLING UPON RESOURCES External Internal - finances - faith - family - memories - friends - self-confidence - neighbours - fighting spirit - personal attributes  REDEFINING INDEPENDENCE & CONNECTEDNESS - normalizing threats - new ways of achieving independence & connectedness - reappraising situation  to  A n o t h e r woman  said:  R. A s we g e t o l d e r , we d o n ' t f e e l we n e e d t h o s e e x c i t i n g t h i n g s t h a t meant s o much b e f o r e . A n o t h e r woman was a s k e d : I.  I s contentment  more i m p o r t a n t t h a n h a p p i n e s s ?  R. I f y o u a r e c o n t e n t , y o u a r e h a p p y . C o n t e n t m e n t i s an e x t e n d e d form o f h a p p i n e s s . I f y o u a r e g o i n g t o d i v i d e them t h e n y o u w o u l d make h a p p i n e s s a r e a l b i g deal. And  finally:  R. I t ' s n o t a n e x c i t a b l e h a p p i n e s s b e c a u s e my l i f e i s c a l m now. Some p e o p l e m i g h t s a y b o r i n g b u t t o me i t ' s not boring T h e r e i s n o t h i n g p r e s s i n g me now. T h e r e i s no s t r e s s . Excerpts  from t h e t r a n s c r i p t s  not p e r c e i v e d as a s t a t i c  indicate that  c o n t e n t m e n t was  phenomenon. One 79 y e a r o l d woman  said: R. I t h i n k y o u ' v e g o t t o k e e p g r o w i n g . T h e r e i s s o m e t h i n g c a l l i n g me o n f o r a n o t h e r way, a n o t h e r p e r i o d o f time, n o t as long, b u t n e v e r t h e l e s s interesting. I t became a p p a r e n t t h a t c o n t e n t m e n t mind t h a t  was a d e s i r e d  e a c h woman d e s i r e d . However, c o n t e n t m e n t  t h e c e s s a t i o n o f p e r s o n a l growth, associate a specific Further analysis  activity  state of  d i d n o t mean  n o r was i t p o s s i b l e t o  level with  contentment.  of the participants'  stories  r e v e a l e d two  o t h e r themes t h a t were c o n c e p t u a l i z e d a s " i n d e p e n d e n c e " a n d "connectedness".  Independence  two s o u r c e s o f c o n t e n t m e n t .  a n d c o n n e c t e d n e s s a p p e a r e d t o be  Independence  was c h a r a c t e r i z e d a s  s e l f - r e l i a n c e w h i c h meant n o t h a v i n g t o b o t h e r o r i n c o n v e n i e n c e o t h e r p e o p l e and b e i n g i n c o n t r o l o f t h e i r p e r s o n a l daily  activities.  l i v e s and  34 One woman d e s c r i b e d h e r view of independence: R. Ah w e l l independence i s something t h a t ah I'm n o t b e i n g a b o t h e r t o anybody e l s e . I l i k e s e l f - r e l i a n c e . I.  S e l f - r e l i a n c e , so independence i s s e l f - r e l i a n c e ?  R. A b s o l u t e l y , t o me i t i s . T h i s same woman had been dependent upon o t h e r s f o l l o w i n g an automobile a c c i d e n t . Her d e s c r i p t i o n of h e r e x p e r i e n c e s as both an independent and a dependent person, enhances o u r u n d e r s t a n d i n g o f t h e importance of independence and thus i t s l i n k t o contentment. She concluded: R. So t h a t i s t h e one t h i n g t h a t I've always dreaded was t h e f a c t of h a v i n g been so independent. I can't stand t h e thought o f having t o r e l y on somebody e l s e . I've had enough o f t h a t i n t h e h o s p i t a l , t e l l i n g you when t o g e t up, when t o go t o bed, when t o t a k e a p i l l and I'm n o t v e r y good a t t a k i n g o r d e r s . ... One t h i n g I dread i s g e t t i n g t o the p o i n t o f h a v i n g t o ask f a v o u r s o f p e o p l e . I can't stand f a v o u r s . I.  So independence i s p r e t t y important t o you?  R. My God i t ' s my l i f e . Without t h a t you would be l o s t . I f you g i v e up t h a t you've got n o t h i n g t o f i g h t w i t h . I t h i n k keeping your independence as much as you can i s o f a tremendous h e l p because without t h a t you c o u l d end up i n a n u r s i n g home and be t o t a l l y dependent on o t h e r people. T h i s i s something t h a t you hate t o g i v e up, t h a t l a s t l i t t l e b i t of independence. O b v i o u s l y independence was a v i t a l component o f h e r l i f e and a source o f contentment. F o r some women, independence meant not  b e i n g a b o t h e r t o t h e i r f a m i l i e s . An 80 y e a r o l d woman  d e s c r i b e d h e r view o f independence. R. Independence i s n o t having t o p u t anyone e l s e out or be i n t h e way o r i n t e r f e r e w i t h t h e f a m i l y . F i n a l l y , independence was c h a r a c t e r i z e d by h a v i n g c o n t r o l over t h e i r l i v e s i n t h a t they were a b l e t o manage d a i l y events  35  and p e r s o n a l a f f a i r s . One woman d e s c r i b e d t h e d i f f i c u l t y she e x p e r i e n c e d when she l o s t some o f h e r c o n t r o l . She s a i d : R . I had a bad f a l l and t h a t r e a l l y upset me because I was n o t a b l e t o f u n c t i o n on my own. I had a woman come i n and g e t t h e meals ready and she'd have t o be here an hour o r two and t h a t k i n d of t h i n g . I t r e a l l y upset me n o t t o be i n c o n t r o l of e v e r y t h i n g myself. I l i k e as you p r o b a b l y know by now t o be i n p r e t t y f i r m c o n t r o l . That's t h e way I am, I haven't any i n t e n t i o n of t r y i n g t o change i t . The women i n t h i s study v a l u e d t h e i r independence h i g h l y as i t was a source of contentment. be no more so than "connectedness".  very  However, i t proved t o  Connectedness  was  c h a r a c t e r i z e d by a sense o f b e l o n g i n g w i t h o t h e r people and c o n t i n u e d involvement w i t h l i f e .  T h i s sense o f b e l o n g i n g  o c c u r r e d through r e l a t i o n s h i p s and involvement w i t h t h e i r  family  and f r i e n d s . One woman b e s t i l l u s t r a t e d t h i s i n h e r d e s c r i p t i o n of  h e r r e l a t i o n s h i p w i t h h e r daughter a t t h i s stage i n t h e i r  lives. R. You a r e n o t l i k e mother o r daughter. You a r e more j u s t l i k e f r i e n d s . Now t h a t they've got c h i l d r e n , I've got c l o s e r t o them. I r e a l l y enjoy my g r a n d c h i l d r e n . Another woman s a i d : R. We [daughters and h e r s e l f ] a r e buddies. Another woman t a l k e d about h e r involvement and dependence on h e r p e e r s . R. Now I belong t o a group a t t h e church. We got q u i t e dependent on each o t h e r and most o f them widowed s i n c e I was. They are good f r i e n d s and c a r i n g people and people who k i n d o f , w e l l i f I don't t u r n up a t church, phone and ask what happened, a r e you okay? Having a r e l a t i o n s h i p and involvement w i t h f r i e n d s was important b u t i t was a l s o important t o be connected t o , and  36  p a r t i c i p a t e i n , world events and everyday  l i f e . One woman o f 79  described her f e e l i n g s : R. I always f e e l t h a t every new e x p e r i e n c e , I don't want t o s a y no t o . I t does make l i f e more i n t e r e s t i n g , t h a t i s p a r t of t h e f u n of l i v i n g . I've g o t my f i n g e r s i n q u i t e a few p i e s . I f e e l t h a t t h e r e i s a l o t t h a t I want t o do t h a t I'm not going t o have enough time t o do, so I t r y t o do a l l t h a t I can. Involvement w i t h l i f e d i d not always mean a c t i v e p h y s i c a l involvement.  Involvement o c c u r r e d i n a v a r i e t y o f ways. One  woman s a i d : R. I r e a l i z e my l i m i t a t i o n s r i g h t now. I can't go o u t and s k i p around. ... I don't t h i n k my views have changed t o o much. I read t h e paper from one end t o t h e o t h e r , I do watch a l l the news and I know what i s going on. I l i k e time t o myself. I never g e t bored because I read a l o t . I.  So you a r e s t i l l v e r y i n v o l v e d r i g h t now?  R. M e n t a l l y yes, but not p h y s i c a l l y . I.  So t h e way t h a t you a r e i n v o l v e d does change?  R. Oh yes, y e s . Involvement may a l s o mean being aware o f and a p p r e c i a t i n g n a t u r e . The r e s e a r c h e r asked one woman: I.  What would I see i f I were s t a n d i n g i n your  shoes?  R. A l l r i g h t you a r e s t a n d i n g i n my shoes and you a r e j u s t t h r i l l e d by what you see. You l o v e t h e mountains, you l o v e t h e t r e e s and you l o v e e v e r y t h i n g about i t , and I l o v e l i f e and I l o v e l i v i n g . I can go and j u s t watch t h e r i v e r and t h e b i r d s down t h e r e . I have a f e e l i n g o f peace and happiness. I don't t h i n k I w i l l get over t h e l o v e of l i f e and l i v i n g , so many o f those wonderful t h i n g s . All  o f t h e women i n t h e study experienced a sense o f  b e l o n g i n g w i t h t h e i r f a m i l y and f r i e n d s . They c o n t i n u e d t o be i n v o l v e d w i t h l i f e and nature, but t h e manner and mechanisms of t h e i r involvement  appeared  t o change as they grew o l d e r . Through  37  f u r t h e r a n a l y s i s , i t became apparent t h a t contentment and i t s s o u r c e s , independence and connectedness, were p i v o t a l p a r t s of a l a r g e r dynamic p r o c e s s . Thus, i t became c l e a r t h a t  contentment  c o n s i s t e d o f a number o f phases. The r e s e a r c h e r l a b e l l e d them: h a v i n g contentment, e x p e r i e n c i n g t h r e a t s which d i s r u p t e d contentment, c a l l i n g upon r e s o u r c e s t o c o u n t e r a c t t h e t h r e a t s , and r e d e f i n i n g independence and connectedness. By r e d e f i n i n g t h e i r independence and connectedness a f t e r e x p e r i e n c i n g t h r e a t s , the women  were a b l e t o r e t u r n t o a s t a t e o f contentment. These  phases c o n s t i t u t e d t h e l a r g e r p r o c e s s o f t h e c y c l e o f contentment. The remainder of the c h a p t e r d e s c r i b e s the phases in  detail. Threats The women's s t a t e of contentment was d i s r u p t e d by a number  of t h r e a t s , some o f which c r e a t e d i r r e v e r s i b l e changes. These t h r e a t s i n t e r f e r e d w i t h the women's independence and connectedness. The t h r e a t s i d e n t i f i e d i n t h i s study were: h e a l t h problems, death o f a spouse, death of f r i e n d s and t h e a t t i t u d e s and a c t i o n s of o t h e r s . H e a l t h problems made i t more d i f f i c u l t f o r many o f t h e women t o c o n t i n u e t o manage on t h e i r own o r t o s o c i a l i z e w i t h t h e i r f r i e n d s . H e a l t h problems i n t e r f e r e d w i t h t h e i r a b i l i t y t o have independence and connectedness, thus c a u s i n g discontentment. One woman d e s c r i b e d the impact of angina on both h e r independence and connectedness: R. I have angina and t h a t slows me down... I can't do t h i n g s when I want. I might j u s t take t h e n o t i o n and  38 go. I ' v e a l w a y s b e e n i n d e p e n d e n t . I m i g h t j u s t w a l k o r I m i g h t phone someone a n d s a y do y o u want t o meet me f o r t e a . B u t I c a n ' t do t h a t b e c a u s e I h a v e n ' t g o t t h e strength. T h i s woman t o l d lived  too long,  the researcher that  an i n d i c a t i o n  she f e l t  that  she had  o f h e r d i s c o n t e n t m e n t . The  r e s e a r c h e r a s k e d a n o t h e r woman o f 75 who h a d a number o f h e a l t h problems,  how h e r l i f e  was d i f f e r e n t  now compared t o when s h e  was 6 0 . She s a i d : R. T h a t ' s o n e t h i n g a t a g e 6 0 I h a d s o much t o d o , s o many i n v o l v e m e n t s , a n d now I am l e f t w i t h v e r y few, n o t b e c a u s e t h e o p p o r t u n i t i e s a r e n ' t t h e r e o r my f r i e n d s a r e n ' t t h e r e . I t ' s t h e f a c t t h a t I am n o t p h y s i c a l l y a b l e t o do i t . I . I s i t a n y d i f f e r e n t k e e p i n g i n v o l v e d now t h a n c o m p a r e d t o maybe 2 0 y e a r s ago? R. I n a d i f f e r e n t way b e c a u s e 2 0 y e a r s ago I was d o i n g a c t i v i t i e s much d i f f e r e n t , more a c t i v e . You d i d t h i n g s t h a t I c o u l d n ' t dream o f d o i n g t o d a y b e c a u s e I haven't g o t t h e c a p a c i t y . A n o t h e r woman d e s c r i b e d problem to  that  t h e consequences  a f f e c t e d h e r independence.  of a health  She was no l o n g e r a b l e  do h e r g a r d e n i n g . She s a i d : R. I t i s [ t h e g a r d e n ] t h e one t h i n g t h a t I t r e a s u r e m o s t i n a l l o f my l i f e I t h i n k a t t h e moment, b u t I'm g o i n g t o l e a v e i t b e c a u s e i t ' s g o t t o o much f o r me. H e a l t h problems  discontentment Another connectedness on t h e i r  p r o v e d t o be a m a j o r  f o r t h e women i n t h i s  serious  source of  study.  t h r e a t t o t h e women's i n d e p e n d e n c e a n d  was t h e d e a t h o f a s p o u s e . Women who h a d d e p e n d e d  h u s b a n d s t o manage t h e i r  financial affairs  t h e m s e l v e s w i t h o u t t h e e x p e r t i s e t h e y needed  found  t o manage o n t h e i r  own when t h e y became widows. One woman d e s c r i b e d h e r s i t u a t i o n .  39  R. I'm one of those wives who had someone t o look a f t e r t h i n g s [ f i n a n c e s and investments] f o r her and I d i d n ' t bother w i t h i t . He" would say, "I looked i n t o t h i s and i t seems s a f e and r e a s o n a b l e " . I s a i d "sure dear," and i t would go i n one ear and out the o t h e r . Now I r e a l i z e I should have l i s t e n e d . I would have been b e t t e r o f f now had I taken more i n t e r e s t and f a c e d the f a c t t h a t t h i s [ h i s death] c o u l d have happened t o me. Other women depended on t h e i r husbands f o r  companionship.  With the husband's death, they were l e f t alone and l o n e l y . woman d e s c r i b e d her  One  feelings:  R. You are not l o o k i n g f o r sex but you are m i s s i n g the l o v e and the arm put around you and the t h o u g h t f u l n e s s of b e i n g w i t h you and the c l o s e n e s s . Husbands were a l s o depended on t o p r o v i d e p r a c t i c a l a s s i s t a n c e , such as d r i v i n g a t n i g h t . Thus the death of t h e i r husbands c o u l d narrow t h e i r s o c i a l world. One woman gave the f o l l o w i n g example: R. When you've been used t o a husband and a c a r t o d r i v e you, i t ' s an e n t i r e l y d i f f e r e n t l i f e and when you get on your own, you a r e n ' t a b l e t o depend on anyone f o r t r a n s p o r t a t i o n . I have t o spend more time i n the house. I had a g r e a t d e a l of evening entertainment i n those y e a r s . Now i t ' s become a seldom t h i n g r e a l l y , i t ' s a t u r n around. Sometimes I get bothered by i t . The death of spouses  can c r e a t e a s e r i o u s t h r e a t s t o  women's a b i l i t y t o m a i n t a i n t h e i r independence and connectedness. independent  The p a r t i c i p a n t s had t o f i n d new ways of b e i n g  and connected i n o r d e r t o r e g a i n a sense of  contentment. L o s i n g f r i e n d s a l s o i n t e r f e r e d w i t h the women's contentment. A f t e r age 70 they l o s t many f r i e n d s w i t h i n a r e l a t i v e l y s h o r t p e r i o d of time. One  88 y e a r o l d woman  d e s c r i b e d what happened when she updated her telephone book.  40  R. So many o f my f r i e n d s have passed on. I was t r y i n g to make a new telephone d i r e c t o r y and I c r o s s e d out t h i s one and t h i s one, my c l o s e f r i e n d s . Another woman s a i d : R. My f r i e n d s a r e going, l e a v i n g f o r some reason and another and i t ' s going t o be l e s s and l e s s t o g e t h e r n e s s . In t h e p a s t two years f o r i n s t a n c e I've l o s t t h r e e o r f o u r o f my v e r y c l o s e f r i e n d s t h a t have d i e d on me and so t h i n g s a r e going t o change w i t h o r without your p e r m i s s i o n . That's t h e way l i f e goes on. One f i n a l t h r e a t t o t h e women's contentment was t h e a t t i t u d e s and a c t i o n s of o t h e r s . The women r e l a t e d how o t h e r people c o u l d i n t e r f e r e w i t h t h e i r independence and connectedness. based  T h e i r a c t i o n s c o u l d be w e l l - i n t e n d e d o r simply  on i g n o r a n c e . F o r example, one woman d e s c r i b e d t h e c a r i n g  a c t i o n s o f h e r daughter. R. My daughter takes t h e mother r o l e . Mother go and s i t down, I ' l l do i t . Come on Mom take i t easy. T h i s i s v e r y p r o t e c t i v e . I t makes you laugh, you f e e l q u i t e as a b l e as she t o g e t i n t h e r e and do something f o r supper when t h e f a m i l y i s coming home but she would r a t h e r see you s i t and r e s t . So you g i v e i n t o make her happy. T h i s woman f e l t t h a t she was capable o f b e i n g but h e r daughter's  independent,  protective actions inadvertently interfered  w i t h t h a t independence. Another woman d e s c r i b e d t h e a c t i o n s of s t r a n g e r s a t a bus s t o p . The s t r a n g e r s assumed t h a t she needed h e l p , but they unknowingly i n t e r f e r e d w i t h h e r a b i l i t y t o m a i n t a i n h e r independence. She s a i d : R. The o t h e r day I was w a i t i n g a t t h e bus s t o p . Immediately t h e i r eyes go down t o t h a t w a l k i n g cane and I need i t because I can't be without i t . Immediately two people jumped t o my r e s c u e , one h e l p s me w i t h one arm and I f e l t d r e a d f u l . You know I r e a l i z e they thought they were b e i n g h e l p f u l but I c o u l d have done w i t h l e s s of i t . A l i t t l e b i t o f h e l p  41 but people, mostly people a r e v e r y k i n d but t h e y r a t h e r overdo i t . I thought oh my God, maybe I look about a hundred and one years o l d and they t h i n k I need a l l t h i s a s s i s t a n c e . I r e a l l y r e s e n t t o o much o f t h a t . You see i f they would o n l y l e t me t r y . A 80 y e a r o l d woman d e s c r i b e d how a bus d r i v e r ' s i m p a t i e n t a t t i t u d e affected her: R. What r e a l l y upset me was one day I was on t h e bus and t h e bus was crowded and I had t o be k i n d of back and when i t came time f o r me t o g e t o f f I p u l l e d t h e b i g t h i n g , and by t h e time I got up t o t h e door t o g e t o f f t h e bus d r i v e r had s t a r t e d t h e bus. I s a i d , " Oh I want t o g e t o f f here". And he gave me t h e d i r t i e s t l o o k . He s a i d , "You mean t o t e l l me i t took t h a t l o n g to g e t from t h e r e t o here?" I s a i d , "I've g o t a bad knee and people were t h e r e and I c o u l d n ' t g e t through. I f I c o u l d have g o t here any sooner I would have". But oh he was so n a s t y . He s a i d ,"Well i n t h a t case you s h o u l d n ' t be r i d i n g t h e buses". Oh I f e l t t e r r i b l e . I f e l t f o r awhile I would r a t h e r walk than r i d e on a bus. I j u s t hated t o g e t on and o f f t h e buses. That one bus d r i v e r j u s t turned me o f f g e t t i n g on buses. I would r a t h e r walk than g e t on a bus. T h i s woman no l o n g e r uses p u b l i c t r a n s p o r t a t i o n and thus has t o r e l y on o t h e r s t o h e l p h e r complete  h e r e r r a n d s . In h e r  case, someone e l s e ' s t h o u g h t l e s s words have impaired h e r a b i l i t y to  m a i n t a i n h e r independence. The d a t a i n t h i s study i d e n t i f i e d a number o f t h r e a t s t o  the women's independence and connectedness. i n c l u d e d h e a l t h problems,  These t h r e a t s  t h e death of a spouse and f r i e n d s , and  the a t t i t u d e s and a c t i o n s o f o t h e r s . In o r d e r t o c o u n t e r a c t these t h r e a t s , t h e women drew upon t h e i r r e s o u r c e s , t h e next phase o f t h e c y c l e , so t h a t they c o u l d r e t u r n t o a s t a t e of contentment. Resources The women's s t o r i e s d e s c r i b e d what t h e r e s e a r c h e r c o n c e p t u a l i z e d as e x t e r n a l and i n t e r n a l r e s o u r c e s . E x t e r n a l  42 resources and  included  financial  t h e companionship  contrast,  security,  o f f r i e n d s , and a c c e s s i b l e  i n t e r n a l resources  from w i t h i n  t h e women. T h e s e  resources  included  identity,  and a f i g h t i n g s p i r i t .  of personal  external  External All  enhanced  the threats  acted  played  they  In  arose faith,  and s e l f -  T h e women a l s o  a t t r i b u t e s which  family,  strong  self-confidence  and i n t e r n a l resources  counteracting  described  as resources.  important  a  Both  roles i n  t o contentment.  Resources o f t h e women c l a i m e d  resources.  Their  differently for  health,  intangible;  good  of  neighbors.  were more  memories,  number  the support  stories revealed  as they  material  t o have  things  got older.  adequate  that  they  financial  used  their  O n e woman d e s c r i b e d  had changed.  money  how h e r n e e d  She s a i d :  R. When y o u a r e y o u n g , a l l y o u c a n t h i n k a b o u t i s h a v i n g y o u r f a m i l y , g e t t i n g a home a n d h a v i n g n i c e t h i n g s , b u t once you've g o t them a l l , you've g o t them. Adequate the  finances  women t o p u r c h a s e  independence  an e x t e r n a l  services  that  and connectedness.  enough money a l l o w e d way.  were  resource  helped  them  that  to retain  O n e woman d e s c r i b e d  her to entertain  enabled  her friends  how  their  having  i n a  modified  She s a i d : R. I t ' s [ p r e p a r i n g m e a l s ] j u s t a l i t t l e m o r e d i f f i c u l t t h a n i f t h e r e were t h e two o f y o u . So I j u s t a s k t h e [ f a m i l y a n d f r i e n d s ] f o r d i n n e r a n d t a k e them o u t . Fortunately, I am f i n a n c i a l l y a b l e t o d o i t . Another  supportive the  external  family  resource  provided  women t o r e m a i n  was a s u p p o r t i v e  extra  i n their  assistance  family.  which  own h o m e s . A n 80 y e a r  A  helped old  some o f  woman  d e s c r i b e d h e r c l o s e r e l a t i o n s h i p w i t h h e r c h i l d r e n who p r o v i d e d p r a c t i c a l h e l p and made h e r f e e l secure. She s a i d : R. I've been c l o s e t o my k i d s . There's n o t a day goes by t h a t I don't hear from one o f them, always. I f i t ' s not i n t h e daytime, i t ' s u s u a l l y a t n i g h t . I f I need anything that's i t . F r i e n d s were a l s o important  r e s o u r c e s . One woman s a i d :  R. I s t i l l have these f r i e n d s t h a t I worked w i t h so many years ago. We laugh and t a l k about t h e o l d days and how much we were p a i d . ... I l o v e them a l l r e a l l y , they a r e important t o me. Another woman s a i d : R. I have l o t s of good f r i e n d s , I am t r u l y b l e s s e d w i t h good f r i e n d s . Neighbors were a l s o important  r e s o u r c e s f o r women who had  l i v e d i n t h e same neighborhood f o r y e a r s . Although  they d i d n o t  p r o v i d e a c t u a l a s s i s t a n c e , t h e women c o u l d c a l l upon them f o r h e l p . One woman d e s c r i b e d t h e r o l e o f h e r n e i g h b o r s . She s a i d : R. I f a n y t h i n g d i d go wrong, I know I've g o t a l l these o l d neighbors t h a t I c o u l d always g e t i n touch w i t h somebody. I know I'm not on my own r e a l l y . The e x t e r n a l r e s o u r c e s of f i n a n c i a l s t a b i l i t y ,  support o f  f a m i l y , companionship of f r i e n d s and a c c e s s i b l e neighbors a s s i s t e d t h e women i n modifying t h e n e g a t i v e impact  of t h e  t h r e a t s d e s c r i b e d i n t h e p r e v i o u s s e c t i o n . The r e s o u r c e s appeared t o augment t h e i r a b i l i t y t o m a i n t a i n t h e i r independence and connectedness so t h a t they c o u l d r e t u r n t o a s t a t e o f contentment. I n t e r n a l Resources I n t e r n a l r e s o u r c e s were d i f f e r e n t from t h e e x t e r n a l r e s o u r c e s b u t they a l s o helped t o c o u n t e r a c t t h e t h r e a t s t o t h e women's independence and connectedness.  Their stories revealed a  44 number o f a s s e t s t h a t were d i f f e r e n t from t h e c o n c r e t e , t a n g i b l e external resources.  I n t e r n a l resources were l e s s v i s i b l e and  appeared t o o r i g i n a t e w i t h i n t h e women. In t h i s study, resources  included  internal  s t r o n g f a i t h , memories, good h e a l t h ,  enhanced s e l f - c o n f i d e n c e o r s e l f - i d e n t i t y , a f i g h t i n g s p i r i t and f i n a l l y a combination o f p e r s o n a l a t t r i b u t e s t h a t t h e women acquired i n l a t e r Strong  life.  f a i t h appeared t o a s s i s t t h e women t o s t r i v e f o r and  r e g a i n a s t a t e o f contentment f o l l o w i n g a t h r e a t e n i n g event. One woman p r o v i d e d t h e f o l l o w i n g d e s c r i p t i o n o f h e r f a i t h : R. W e l l I f e e l and I always have f e l t s i n c e I was a c h i l d t h a t I have h e l p from e i t h e r w i t h i n o r a h i g h e r b e i n g . So I have f a i t h t h a t whatever I am g i v e n t o bear, I have t h e s t r e n g t h t o go on. Another woman s a i d : R. I c o u l d n ' t g i v e up, [ a f t e r h e r husband d i e d ] I know some people do. No something i s pushing me always s u p p o r t i n g me. Which I b e l i e v e i s my f a i t h . Come, move on. T h i s f a i t h appeared t o p r o v i d e t h e women w i t h s t r e n g t h and guidance e n a b l i n g them t o f e e l t h a t they c o u l d go on w i t h  their  lives. Memories were another important Memories enabled  internal  resource.  the women t o r e m i n i s c e and remain connected  w i t h t h e p a s t . As w e l l , memories were used i n a t h e r a p e u t i c way. One  o f t h e women d e s c r i b e d h e r view of memories. R. W e l l memories a r e so important t h a t i f you were down, you can t h i n k of a l l t h e n i c e t h i n g s and a l l t h e p l e a s a n t t h i n g s and a l l the n i c e p l a c e s you went and how n i c e you g o t along t o g e t h e r . So you've g o t no r e g r e t s . . . . I t ' s the memories and t h e p l e a s a n t n e s s and the d i f f e r e n t t h i n g s t h a t you d i d t o g e t h e r t h a t h e l p s you when you a r e down and alone.  Memories then, h e l p e d each  woman t o remain connected t o  her p a s t . They reminded them of h a p p i e r t i m e s . They were a l s o used t o r e p l a c e t h e p h y s i c a l presence o f a dead person which reduced t h e p a i n a s s o c i a t e d w i t h t h e g r i e v i n g p r o c e s s . Enhanced  s e l f - c o n f i d e n c e and a s t r o n g s e l f - i d e n t i t y was  another i n t e r n a l r e s o u r c e . The women appeared a t ease w i t h themselves and s e l f - a s s u r e d . A 79 y e a r o l d woman s a i d : R. I t ' s [ s e l f - c o n f i d e n c e ] growing l i k e mad. I t ' s b e a u t i f u l . I s u f f e r e d from a l a c k o f c o n f i d e n c e f o r so many y e a r s even as an a d u l t . I'm a f r a i d I f e e l v e r y c o n f i d e n t . I guess p o s s i b l y my age has a b i t t o do w i t h i t because i f they don't l i k e i t , so what? Another woman o f t h e same age added: R. By t h e time you a r e n e a r l y 80 you a r e what you a r e and people know what you a r e and you don't have t o be concerned about what people t h i n k . A t t h i s time i n t h e i r l i v e s they seemed t o have more o p p o r t u n i t i e s t o express t h e i r s e l f i d e n t i t y . One woman s a i d : R. I don't t h i n k I am r e a l l y much d i f f e r e n t i n s i d e me t h a t I have always been. But I'm a l o t f r e e r t o express what I am than what I used t o be. Because I don't have t o l i s t e n t o anybody e l s e . I don't f e e l bound by anyone e l s e ' s p a t t e r n and I don't have t o say, y e s , t h a t i s v e r y nLce, u n l e s s I f e e l t h a t . These women d e s c r i b e d t h e i r new sense o f s e l f o r s e l f c o n f i d e n c e as growing a f t e r t h e age of 70. They appeared t o have the freedom t o make c h o i c e s based on t h e i r own needs and thus enjoyed p e r s o n a l  independence.  Another i n t e r n a l r e s o u r c e t h e women v a l u e d h i g h l y was t h e i r good h e a l t h . The women were v e r y aware o f t h e i r need f o r good h e a l t h and t h e importance of m a i n t a i n i n g i t . said:  One woman  46  R. I t r y t o take v e r y good care o f my l i f e , my h e a l t h . I t h i n k you need your h e a l t h . You have t o be more c a r e f u l w i t h your h e a l t h when you l i v e a l o n e . Although most of t h e women had some type of h e a l t h problem, they focussed  on t h e i r remaining good h e a l t h .  One woman s a i d : R. I'm t h e h e a l t h i e s t of a l l my f r i e n d s . I r e a l i z e t h a t I am w e l l f o r my age and I don't know how long i t w i l l l a s t , but I don't have t o f i g h t t h e b a t t l e of physical disability. Another woman of 79 s a i d : R. I'm b l e s s e d w i t h good h e a l t h and t h a t i s a tremendously g r a t e f u l t h i n g as f a r as I am concerned. Good h e a l t h was a p r e c i o u s resource  f o r these women; they  were aware o f t h e consequences o f l o s i n g i t . To overcome t h r e a t s t o h e r independence i t seemed important f o r each woman t o have a s t r o n g f i g h t i n g s p i r i t . One woman d e s c r i b e d how a t t i t u d e helped  her to regain her  independence a f t e r a major h e a l t h problem. She had been admitted t o a r e h a b i l i t a t i o n f a c i l i t y . She s a i d : R. I had two c h o i c e s , f i g h t and g e t out o f t h a t w h e e l c h a i r o r s i t back with t h e d r o o l e r s . . . . There would o n l y be one c h o i c e t h a t I would make. ... I had t o f i g h t myself t o g e t back i n t o i t [being independent] b u t you know I d i d i t . Without h e r f i g h t i n g s p i r i t , t h i s woman i m p l i e s t h a t she would have l o s t h e r independence which would have compromised her  contentment. The women a l s o r e l i e d upon a combination o f o t h e r  a t t r i b u t e s t o h e l p them meet t h e c h a l l e n g e s  personal  t h a t accompanied t h e  t h r e a t s t o t h e i r independence. The women i m p l i e d t h a t they had  acquired  these a t t r i b u t e s as they grew o l d e r . They d e s c r i b e d  t h e i r a t t r i b u t e s as  follows:  R. ... I know I'm more p a t i e n t when t h i n g s don't come. You l e a r n t o w a i t . You l e a r n t o endure. You don't know how a t h i n g i s going t o t u r n out and whether i t ' s a h e a l t h problem or whether i t ' s j u s t something you j u s t s i t and t r y and work your way through and then some times, and you r e a l i z e t h e r e i s v a l u e and growth i n waiting.  R. I t [ l i f e over 70] takes away the sense of urgency t h a t we have when we are younger.  R. I see t h i n g s w i t h a l i t t l e b i t more compassion than I did.  R. I t h i n k I am more p a t i e n t and ways, more wise. And  I hope I am  i n many  finally:  R. You get v e r y p h i l o s o p h i c a l when you get o l d you know. You say w e l l i t ' s [death] going t o come someday but when? I'm not going t o s i t down w a i t i n g f o r i t . ... you mellow w i t h age. ...You see t h i n g s i n a s o f t e r way. You don't l i v e l i f e so d r a m a t i c a l l y o r get such crazy notions. One  of the p e r s o n a l  a t t r i b u t e s the women had was  a b i l i t y t o d i f f e r e n t i a t e between c h r o n o l o g i c a l age, p h y s i c a l body and  an  a sense of i n n e r s e l f t h a t remained  the aging ageless.  R. I s h a l l be 75 i n a few days time. Only when I put i t i n t o words do I r e a l i z e t h a t i t i s on the up and up. B a s i c a l l y , I never t h i n k about o l d age, because the number of y e a r s t h a t you've got on you has any c o n n e c t i o n r e a l l y . You don't n e c e s s a r i l y f a l l a p a r t because you are going t o be 75.  R.  I'm  80 but  I don't f e e l o l d .  48 R. The c a l e n d a r t e l l s me t h a t I'm an o l d person, b u t I don't f e e l o l d . The women d e s c r i b e d R. I t ' s a d o w n h i l l out.  t h e i r aging p h y s i c a l  bodies.  t h i n g p h y s i c a l l y . You are wearing  R.You don't do t h i n g s as w e l l o r as f a s t as you used t o . The f a c t t h a t I f o r g e t t h i n g s . . . t h e f a c t t h a t I c o u l d maybe have a l i t t l e more t r o u b l e t a k i n g t h e t o p o f f a j a r than I would have t e n y e a r s ago. The f r u s t r a t i n g l i t t l e t h i n g s a r e t h e t h i n g s I t h i n k o f as aging. The women had t h e a b i l i t y t o d i f f e r e n t i a t e between t h e i r aging b o d i e s and t h e i r sense of i n n e r s e l f . One 79 y e a r o l d woman s a i d : R. I don't t h i n k [ p l a s t i c surgery] would be j u s t i f i e d i n my case, b u t i t would be l o v e l y because I would be as young as I f e e l when I looked i n t h e m i r r o r . Another woman d e s c r i b e d  the c o n t r a s t between h e r e x t e r n a l  aging body w i t h h e r i n t e r n a l s e l f . R. You see y o u r s e l f i n a window and you t h i n k who i s t h a t o l d woman, and i t i s y o u r s e l f . The women's a b i l i t y t o not f e e l o l d d e s p i t e t h e f a c t  that  t h e i r b o d i e s were g e t t i n g o l d e r was an important r e s o u r c e . F o r t h e i r s t o r i e s r e v e a l e d t h a t t o be o l d was i t s e l f a t h r e a t . Being old  was a s s o c i a t e d w i t h p o s s e s s i n g  c o n t r o l and being One  fewer a b i l i t i e s , h a v i n g l e s s  less involved.  80 y e a r o l d woman d e s c r i b e d  old as:  R. ...one morning you go t o g e t out o f bed and you can't g e t out o f bed, then you say w e l l I must be o l d . Another woman added: R. When I b e g i n t o f e e l t h a t I have t o have s p e c i a l  49  a t t e n t i o n shown t o me, then I w i l l t h i n k t h a t I'm old.  R. I t doesn't a l l of a sudden happen u n l e s s you have a v e r y bad a c c i d e n t and you a r e i n c a p a c i t a t e d . And  finally:  R. I t h i n k an o l d person i s a person t h a t has allowed themselves t o become o l d not o n l y i n y e a r s , b u t i n f e e l i n g s and a t t i t u d e s and t h i n g s l i k e t h a t . The women's a b i l i t y t o d i f f e r e n t i a t e between t h e i r p h y s i c a l bodies,  advanced c h r o n o l o g i c a l age and t h e i r  i n n e r s e l f was another resource personal  aging  ageless  o f g r e a t importance. These  a t t r i b u t e s were important t o t h e women f o r t h e y c o u l d  be drawn upon t o h e l p t h e women r e d e f i n e t h e i r independence and connectedness. T h i s study r e v e a l e d many resources e i g h t o l d e r women. E x t e r n a l resources  a v a i l a b l e t o these  appeared t o a s s i s t t h e  women i n m o d i f y i n g t h e impact of t h r e a t s t o t h e i r independence and  connectedness. I n t e r n a l resources  arose from w i t h i n t h e  women and appeared t o be more s p e c i f i c a l l y a s s o c i a t e d w i t h  being  an o l d e r woman. By drawing upon a l l o f t h e i r resources t h e women were a b l e t o move towards r e d e f i n i n g t h e i r independence and  connectedness, t h e next phase o f t h e c y c l e i n t h e r e t u r n t o  contentment. Redefining The  Independence and Connectedness  f o u r t h phase o f t h e c y c l e begins w i t h choosing t o  overcome t h e impacts of t h e t h r e a t s i n order t o r e t u r n t o contentment. The f o l l o w i n g quotes d e s c r i b e t h i s  choice.  50  R. Now I t h i n k a l l of us come t o c r o s s r o a d s i n our l i v e s where we make a c h o i c e of which way t o go o r what we do i n a s i t u a t i o n , t h a t we know t h e r e has t o be a change i n what we do.  R. You must c a r r y on. You can't c a l l i t q u i t s j u s t l i k e t h a t , you have t o go on. I t might be a l i t t l e h a r d e r but i t doesn't h u r t you. You might f i g u r e , oh i t takes you a b i t more time and a l i t t l e b i t more p a t i e n c e but i f you make up your mind, you can do i t . Not and  a l l women made a c h o i c e t o r e g a i n t h e i r independence  connectedness. One  woman who  had r e l u c t a n t l y agreed w i t h  her  c h i l d r e n t h a t she should r e t i r e d e s c r i b e d what she d i d soon after  retirement: R. I j u s t d i d n ' t get up. Oh I'd get up f o r my meals and get bathed and t h a t , but I d i d n ' t t r y . I j u s t l a i d t h e r e and read and my daughter and her husband would come i n and t h i s was t h e i r doing. I was q u i t e capable of doing my own. Now I have homemakers. T h i s woman allowed  did  others t o be r e s p o n s i b l e f o r her.  not t r y t o r e g a i n her  She  independence.  A f t e r they chose t o r e t u r n t o a s t a t e of contentment, women d e s c r i b e d a number of a c t i o n s t h a t the r e s e a r c h e r " r e d e f i n i n g independence and  connectedness". The  the  labelled  researcher  i d e n t i f i e d t h r e e ways of r e d e f i n i n g independence, i n c l u d i n g f i n d i n g new  ways t o be independent and  connected,  t h r e a t s t h a t accompany aging and r e a p p r a i s i n g the Even women who  had been confronted  normalizing situation.  by t h r e a t s which caused  i r r e v e r s i b l e changes were a b l e t o r e g a i n t h e i r independence connectedness. One  woman d e s c r i b e d how  husband f o r companionship and  support.  she depended on  and  her  A f t e r he d i e d , she wanted  51  to  continue  l i v i n g i n t h e house b u t she had t o do so a l o n e . She  d e s c r i b e d how she was a b l e t o become independent. R. I had a job o f a c c e p t i n g how I was going t o manage b e i n g alone by myself a t n i g h t and t h e s e c u r i t y o f coming i n t o t h e house and e v e r y t h i n g w i l l be a l l r i g h t . So I had t o t h i n k of t h i n g s t h a t bothered me and f i g u r e d t h e b e s t way t o s o l v e i t by p u t t i n g bars on t h e bathroom and bedroom windows so t h a t I c o u l d have f r e s h a i r . Make sure t h a t i t was w e l l l o c k e d up i n s i d e and a t t h e t o p of t h e s t a i r s so t h a t I f e l t more secure and then I was a l l r i g h t . I f e l t q u i t e safe. Another woman d e s c r i b e d how a h e a l t h problem i n t e r f e r e d w i t h h e r a b i l i t y t o s o c i a l i z e w i t h h e r f r i e n d s . A i d e d by h e r p h y s i c i a n , she chose t o a t t e n d a s e n i o r s ' day care c e n t r e where she became i n v o l v e d w i t h new f r i e n d s . She d e s c r i b e d h e r situation. R. The d o c t o r s a i d t h a t I've g o t t o g e t out... I used to l i k e bowling b u t I can't do t h a t anymore....I do l i k e t h e c e n t r e because as I say i t ' s g o t me out and I have met you know some r e a l l y n i c e people, a l l t o g e t h e r d i f f e r e n t than t h e bunch I used t o go w i t h . I t i s something t o look forward t o . We go f o r lunch and once a month we go on a t r i p and we go someplace f o r a n i c e lunch. Both of these women found new ways o f b e i n g independent and connected. The r e s e a r c h e r noted i n a p r e v i o u s  section, that the  women l o s t a number o f f r i e n d s i n a r e l a t i v e l y s h o r t p e r i o d of time. T h i s was a t h r e a t t o t h e i r connectedness t h a t they were able t o normalize.  S e v e r a l women d e s c r i b e d how they  resigned  themselves t o l o s i n g f r i e n d s . They looked upon t h e death o f t h e i r f r i e n d s as a l o s s b u t they a l s o remembered and a p p r e c i a t e d what t h e i r f r i e n d s had g i v e n them when they were a l i v e . One woman s a i d : R. You see when you l i v e t o be n e a r l y 80, you develop a r e s i g n a t i o n about l o s i n g f r i e n d s . You know i t i s  going t o happen. You see i t a l l around you. You have l o s t a l o t o f them. And  another woman remarked:  R. I g e t phone c a l l s a t n i g h t and some of them a r e sad and I see so and so i s gone. You have a l i t t l e s i l e n t t e a r and then you r e a l i z e t h a t you enjoyed t h e i r company w h i l e they were t h e r e . P e r s o n a l a t t r i b u t e s and memories, two powerful a s s i s t e d t h e women i n n o r m a l i z i n g t h e l o s s o f t h e i r The  resources, friends.  f i n a l way of r e d e f i n i n g independence and connectednes  o c c u r r e d when t h e women r e a p p r a i s e d t h e i r s i t u a t i o n s . In most cases t h i s meant f i n d i n g t h e p o s i t i v e aspects o f t h e s i t u a t i o n One woman d e s c r i b e d how where once she f e l t a l l alone, she was now a b l e t o c o n c e n t r a t e a l l h e r e n e r g i e s on c a r i n g f o r h e r s e l f She  said: R. I t ' s d i f f e r e n t and you miss these o t h e r people i n one r e s p e c t , b u t on t h e o t h e r hand, you have something e l s e t h e r e you see. I t ' s g o t i t s compensations. I t ' s not r i g h t f o r a person your age. A t my age when you are t i r e d and have t o , and should be a b l e t o , a l l o c a t e a l l o f your own s t r e n g t h s a c c o r d i n g t o your own needs and wishes, i t ' s q u i t e d i f f e r e n t from t h e time when your s t r e n g t h goes t o l o o k i n g a f t e r somebody e l s e . Another woman d e s c r i b e d how she r e a l i z e d t h a t i t was  b e t t e r t h a t h e r husband had d i e d b e f o r e her, because he would not have been a b l e t o look a f t e r h i m s e l f . She s a i d : R. I've g o t t o r e a l i z e one was going t o go f i r s t . I j u s t g o t t o accept i t and I am p l e a s e d i n a way t h a t my husband went f i r s t . I know he wouldn't manage t h e way t h a t I do because a man i s not adept a t t h e same things. She a l s o added: R. I am r i g h t now I have a l i t t l e time t o g e t a d j u s t e d and I am e n j o y i n g myself. I don't mean i t wrong b u t I make my own d e c i s i o n s . I do what I want when I want. I get what I want when I want. I've g o t t o a c c e p t t h a t my p a r t n e r i s n ' t t h e r e so I have t o do i t  5 3  i  m y s e l f . . . . I t ' s a sense of s a t i s f a c t i o n when you make up your mind y o u r s e l f . R e a p p r a i s i n g h e r s i t u a t i o n i n v o l v e d making a c h o i c e t h a t enabled t h i s woman t o m a i n t a i n h e r independence. Another woman did  n o t d w e l l upon t h e l o s s of h e r house and garden but r a t h e r  viewed t h e s i t u a t i o n as one where she c o u l d m a i n t a i n h e r independence by making h e r own c h o i c e s and b e i n g i n c o n t r o l . She d e s c r i b e d h e r circumstances: R. I'm going t o l e a v e i t [the garden] because i t ' s t o o much f o r me. ... I am moving t h e way t h a t I want t o . When I move, I ' l l do i t i n an o r g a n i z e d and reasonable manner, having d e c i d e d what I want t o take w i t h me and what I don't want t o take. Yes, t h a t i s my p l u s t o do i t i n my own way. I am going t o miss t h i s v e r y much because I've been here f o r twenty-two y e a r s . I want t o make t h e move when I want t o and i n t h e circumstances t h a t I choose. Then I w i l l have t h e ego s a t i s f a c t i o n even i f I'm n o t going t o be a l l t h a t happy f o r awhile i n an apartment. Another way o f r e a p p r a i s i n g a s i t u a t i o n was by choosing t o l i v e i n t h e p r e s e n t , r a t h e r than d w e l l on an u n c e r t a i n f u t u r e . One woman s t a t e d : R. Now I j u s t enjoy one day and I am t h a n k f u l f o r t h a t day, i f I g e t another day f i n e . I j u s t seem t o take time as i t goes along. I t ' s more o r l e s s day by day now. I don't make any p l a n s . These women's s t o r i e s demonstrated how they t r i e d t o f i n d the p o s i t i v e a s p e c t s o f a p o t e n t i a l l y d i s t r e s s i n g s i t u a t i o n i n o r d e r t o r e d e f i n e t h e i r independence and connectedness.  When  t h i s stage o f t h e c y c l e was completed, t h e women r e t u r n e d t o a s t a t e o f contentment. T h i s contentment was d i f f e r e n t than a t the b e g i n n i n g o f t h e c y c l e but i t was contentment n e v e r t h e l e s s . A f t e r d e s c r i b i n g a number of t h r e a t e n i n g events, one of t h e women d e s c r i b e d h e r l i f e i n t h i s way:  54  R. I t ' s d i f f e r e n t and i t i s narrower. I t can be j u s t as f u l f i l l i n g and content you know. Summary Chapter f o u r has presented t h e process t h e r e s e a r c h e r l a b e l l e d t h e " c y c l e o f contentment" which o r i g i n a t e d from t h e themes t h a t arose out o f t h e women's s t o r i e s . Contentment was a c y c l i c a l p r o c e s s t h a t i n v o l v e d having contentment, l o s i n g i t and r e g a i n i n g i t . The phases i n t h e c y c l e of contentment h a v i n g independence and connectedness, e x p e r i e n c i n g drawing upon resources  included: threats,  and r e d e f i n i n g independence and  connectedness. Contentment was a form of happiness t h e women d e s i r e d . I t was  c h a r a c t e r i z e d by f e e l i n g s of calmness and freedom from  u n e a s i n e s s . I t seemed t h a t a f t e r age 70, contentment was e a s i l y d i s r u p t e d by a number o f t h r e a t s such as t h e l o s s o f a spouse and  f r i e n d s , d e c l i n i n g h e a l t h and t h e a t t i t u d e s and a c t i o n s of  others.  In response t o these t h r e a t s t h e women drew upon t h e i r  resources. E x t e r n a l resources  i n c l u d e d : adequate f i n a n c e s , and t h e  support of f a m i l y , f r i e n d s and neighbors. I n t e r n a l i n c l u d e d : f a i t h , memories, good h e a l t h , enhanced and  resources  self-confidence  s e l f - i d e n t i t y , a f i g h t i n g s p i r i t , and a number o f p e r s o n a l  a t t r i b u t e s t h a t t h e women a c q u i r e d resources  modified  as they g o t o l d e r . These  t h e impact of t h e t h r e a t s and a s s i s t e d t h e  women t o r e d e f i n e t h e meaning o f t h e i r independence and connectedness. The  researcher  i d e n t i f i e d t h r e e ways of r e d e f i n i n g  independence and connectedness. They i n c l u d e d : f i n d i n g new ways  of e x p e r i e n c i n g independence and connectedness, n o r m a l i z i n g common t h r e a t s t h a t o c c u r i n o l d age and r e a p p r a i s i n g s i t u a t i o n s . When independence and connectedness were r e d e f i n e d , the women were content once more.  56 CHAPTER 5 DISCUSSION OF FINDINGS  Introduction The o v e r a l l purpose o f chapter f i v e i s t o d i s c u s s t h e f i n d i n g s o f t h e study. T h i s d i s c u s s i o n i s d i v i d e d i n t o t h r e e s e c t i o n s . The f i r s t s e c t i o n i l l u s t r a t e s how t h e q u e s t i o n s t h a t d i r e c t e d t h i s study can be answered based on t h e f i n d i n g s o f t h i s study. The second s e c t i o n analyzes t h e u s e f u l n e s s o f t h e concept  o f a c r i t i c a l p e r i o d from t h e UBC model of n u r s i n g  (1987),  as a t h e o r e t i c a l framework f o r t h e study. The f i n a l  s e c t i o n compares t h i s study's f i n d i n g s w i t h those o f o t h e r r e s e a r c h e r s . T h i s examination  i l l u s t r a t e s how c u r r e n t knowledge  of o l d e r women can be enhanced by e l i c i t i n g t h e i r p e r s p e c t i v e s . The Research The two was:  Questions  c y c l e o f contentment p r o v i d e s i n f o r m a t i o n t h a t answers  o f t h e t h r e e r e s e a r c h q u e s t i o n s . The f i r s t r e s e a r c h q u e s t i o n how do women d e s c r i b e t h e gains o r p o s i t i v e  a s s o c i a t e d w i t h t h i s stage o f t h e i r l i f e ?  aspects  T h i s study showed  t h a t contentment i t s e l f can be c o n s i d e r e d a g a i n . Other gains were i d e n t i f i e d i n t h e t h i r d phase o f t h e c y c l e o f contentment, drawing upon r e s o u r c e s . In t h i s phase a number o f i n t e r n a l and e x t e r n a l r e s o u r c e s were i d e n t i f i e d . The women's i n t e r n a l r e s o u r c e s were t h e gains o r p o s i t i v e a s p e c t s a s s o c i a t e d w i t h l i f e over 70. The women i n f e r r e d t h a t by l i v i n g f o r a number of decades and e x p e r i e n c i n g many t h i n g s , they a c q u i r e d these i n t e r n a l r e s o u r c e s which i n  57 some cases were unique t o t h i s stage of t h e i r l i v e s . They v a l u e d t h e i r f a i t h , memories, enhanced s e l f - c o n f i d e n c e , and f i g h t i n g s p i r i t . They were proud o f t h e i r p e r s o n a l a t t r i b u t e s  which were  made up of wisdom, p a t i e n c e , t o l e r a n c e and t h e i r a b i l i t y t o d i f f e r e n t i a t e between t h e i r aging bodies and t h e i r a g e l e s s i n n e r s e l v e s . The study showed t h a t t h e i r i n t e r n a l r e s o u r c e s p l a y e d a v i t a l r o l e i n a s s i s t i n g t h e women t o r e d e f i n e t h e i r independence and connectedness so t h a t they c o u l d r e t u r n t o a s t a t e o f contentment. The  second q u e s t i o n was: how do women d e s c r i b e t h e l o s s e s  o r n e g a t i v e a s p e c t s a s s o c i a t e d w i t h t h i s stage o f t h e i r The  second phase i n t h e c y c l e ,  lives?  experiencing t h r e a t s , provided  the answer t o t h i s q u e s t i o n . The major l o s s e s a t t h i s stage o f t h e i r l i v e s i n c l u d e d : t h e death o f a spouse, death o f f r i e n d s and h e a l t h problems. The study showed t h a t i n l i f e over 70 these l o s s e s seemed t o occur with great The  frequency.  t h i r d q u e s t i o n was: how do women's a c t u a l e x p e r i e n c e of  b e i n g over 70 compare w i t h t h e i r e a r l i e r e x p e c t a t i o n s of themselves a t t h i s stage o f t h e i r l i f e ? The f i n d i n g s i n t h i s study c o u l d n o t answer t h i s q u e s t i o n . The women were unable t o r e c a l l o r v e r b a l i z e any p r e v i o u s e x p e c t a t i o n s about what t h e i r l i f e would be l i k e when they were over 70. T h i s f i n d i n g may be attributed  t o t h e f a c t t h a t these women a r e p a r t of t h e f i r s t  l a r g e c o h o r t group t o reach advanced age. Many o f them l i v e d l o n g e r than t h e i r parents d i d and they o u t l i v e d Although  their  spouses.  t h e r e have been many r e s e a r c h s t u d i e s and v a s t amounts  58 of s t a t i s t i c a l data c o l l e c t e d i n t h e p a s t few y e a r s , these women d i d n o t have access t o t h i s i n f o r m a t i o n . T h e r e f o r e , both t h e l a c k o f o l d e r r o l e models and a p a u c i t y o f p e r t i n e n t i n f o r m a t i o n may  have c o n t r i b u t e d t o t h i s The  finding.  i n f o r m a t i o n from t h e c y c l e of contentment was a b l e t o  answer two out o f t h e t h r e e r e s e a r c h q u e s t i o n s . Contentment and the a c q u i s i t i o n o f i n t e r n a l resources seemed t o be t h e most important  g a i n o r p o s i t i v e aspect o f l i f e over 70. The major  l o s s e s were t h e death o f a spouse, t h e death of f r i e n d s and t h e i n c r e a s e i n h e a l t h problems. T h i s group of e i g h t women c o u l d not a r t i c u l a t e any p r e v i o u s e x p e c t a t i o n s r e g a r d i n g what t h e i r  lives  would be l i k e and thus were unable t o make a comparison between t h e i r e x p e c t a t i o n s and a c t u a l experiences  of b e i n g over 70.  T h e o r e t i c a l Framework The  t h e o r e t i c a l framework was based on t h e concept  c r i t i c a l p e r i o d from t h e UBC model f o r n u r s i n g framework was u s e f u l f o r two reasons.  of a  (1987). T h i s  First, i t s  implementation  i d e n t i f i e d t h e importance of seeking the women's p e r s p e c t i v e s . Second, i t was u s e f u l i n d e s i g n i n g t h e r e s e a r c h  questions.  An unexpected f i n d i n g was t h a t t h e women c o u l d not a r t i c u l a t e any p r e v i o u s e x p e c t a t i o n s about t h i s  maturational  event. However, now t h a t they are i n t h i s m a t u r a t i o n a l  event  they do have e x p e c t a t i o n s . F o r example, i n terms o f body change, they expected  t h a t t h e i r bodies would wear out and they would  slow down. In terms of r o l e changes, they no l o n g e r expected t o have t o look a f t e r t h e i r c h i l d r e n . The e x p e c t a t i o n s  around  59 s o c i a l i n t e r a c t i o n changes i n c l u d e d the acceptance of the  fact  t h a t more of t h e i r f r i e n d s d i e d as the women grew o l d e r . In summary, the concept of c r i t i c a l p e r i o d was framework f o r d i r e c t i n g the r e s e a r c h e r perspectives. research  The  framework was  a useful  t o seek the women's  also useful i n designing  the  questions. C y c l e of Contentment  The  t h i r d s e c t i o n of chapter f i v e d i s c u s s e s  the  findings  from the c y c l e of contentment. An e x p l o r a t i o n of the revealed  literature  t h a t many of the f i n d i n g s t h a t were fundamental i n  c o n c e p t u a l i z i n g the c y c l e of contentment were a l s o noted i n other r e s e a r c h  s t u d i e s . As the r e s e a r c h e r  l i t e r a t u r e that explained  could f i n d  no  the c y c l i c process of contentment,  each of i t s f o u r phases i s considered  separately.  Contentment The  overall  theme i n the c y c l e of contentment  n a t u r a l l y , contentment. Other r e s e a r c h e r s  was,  have noted  the  importance of contentment. George, (1986), i n r e v i e w i n g l i t e r a t u r e on l i f e s a t i s f a c t i o n , the p r e r o g a t i v e  concluded t h a t ,  "Euphoria i s  of youth, whereas contentment i s the reward of  o l d age"(p.6). Two  r e c e n t Canadian s t u d i e s found t h a t  m a j o r i t y of the o l d e r respondents were content and with t h e i r  lives  the  (Connidis,  1987;  the  satisfied  Gooding, Sloan, Amsel, 1988).  In p o p u l a r l i t e r a t u r e , contentment again emerged as a theme. In w r i t i n g a personal (1984) s t a t e d 334).  "I am  Therefore,  j o u r n a l d e s c r i b i n g her l i f e a t 70,  Sarton  coming i n t o a p e r i o d of i n n e r calm"  both p o p u l a r l i t e r a t u r e and  research  (p.  supported  60 t h i s study's f i n d i n g t h a t contentment can be a d e s i r e d s t a t e of mind f o r o l d e r women. The women's p r e f e r e n c e f o r contentment h i g h l i g h t e d a major d i f f e r e n c e between t h e i r l i v e s now compared t o when t h e y were younger. I t seemed t h a t t h e i r d e s i r e f o r contentment and i t s associated progression  calmness and freedom from uneasiness was a n a t u r a l o f events; t h e y c o u l d use t h i s q u i e t e r time t o  r e f l e c t on and make sense of t h e i r l i v e s . Washbourn (1977), i n her quest t o understand t h e wholeness of t h e woman's e x p e r i e n c e , said  "The c r i s i s of o l d age i s n o t undergone i n a day, i t i s a  l e n g t h y p r o c e s s of b r i n g i n g t o g e t h e r , of f i t t i n g t h e p i e c e s o f the p a s t i n t o a whole" (p.146). I t seemed t h a t t h e women's p r e f e r e n c e f o r contentment was n e c e s s a r y i f t h e y were t o complete t h e work o f o l d age w i t h a sense o f peace. Independence and Connectedness T h i s study demonstrated t h a t independence and connectedness are two o f t h e p o s s i b l e sources o f contentment. T h i s was s i m i l a r to,  and y e t d i f f e r e n t from, t h e f i n d i n g s o f o t h e r s t u d i e s which  l i n k e d independence and connectedness t o morale, a sense o f well-being,  l i f e s a t i s f a c t i o n and happiness.  L a r s o n (1978) found t h a t t h e l o s s of independence and a reduction i n s o c i a l i n t e r a c t i o n adversely  affected the older  person's morale. A Canadian study on widowhood showed t h a t independence and s o c i a l involvement c o n t r i b u t e d t o h i g h e r l e v e l s of morale (Harvey e t a l . , 1987). Two q u a l i t a t i v e s t u d i e s i n v o l v i n g o l d e r people a l s o i d e n t i f y t h e importance of both independence and connectedness.  61 A q u a l i t a t i v e study by Myerhoff  (1978) showed how  that while a  group o f o l d e r Jewish people had a s t r o n g d e s i r e f o r independence, t h e y s t i l l d e s i r e d t h e i r sense of c o h e s i o n and sense of community which c o u l d be l i k e n e d t o a sense of connectedness. A second q u a l i t a t i v e study by E r i k s o n , and K i v n i k  (1986) d e s c r i b e d  the o l d e r person's d e s i r e f o r  independence and connectedness. E r i k s o n , who was a t the time the study was  Erikson,  i n his nineties  conducted s a i d " I t i s f a s c i n a t i n g t h a t  we as a people should c l i n g so t e n a c i o u s l y t o our p i p e dream of independence as we become i n c r e a s i n g l y dependent interconnectedness" These r e s e a r c h  on our  (p.328). s t u d i e s confirm  t h a t independence  and  connectedness a r e both important t o o l d e r p e o p l e . However, i n the c y c l e of contentment, both the nature of independence connectedness, the dynamic r e l a t i o n s h i p of independence  and  and  connectedness t o contentment, a r e more c l e a r l y demonstrated. o b t a i n i n g the women's own p e r s p e c t i v e , t o understand how  contentment  t h i s study has h e l p e d us  can be d i s r u p t e d by t h r e a t s .  Experiencing Experiencing  Threats  t h r e a t s i s the second phase i n the c y c l e of  contentment. Numerous r e s e a r c h e r s  have i d e n t i f i e d a number of  t h r e a t s t o the o l d e r person's w e l l - b e i n g major t h r e a t s was explained  By  and morale. One of the  poor h e a l t h . Lohr, Essex and K l e i n (1988)  t h a t h e a l t h problems c o u l d reduce an o l d e r  i n d i v i d u a l ' s a b i l i t y t o communicate and i n t e r a c t s o c i a l l y . Washbourn (1977) noted t h a t a p h y s i c a l d e c l i n e may  be e s p e c i a l l y  62 difficult  f o r women because they have spent a g r e a t p a r t of  t h e i r l i v e s d o i n g t h i n g s f o r o t h e r people. Researchers noted o t h e r t h r e a t s : low incomes, l a c k of s o c i a l i n t e r a c t i o n , l o n e l i n e s s , and l o s s o f support and t h e n e g a t i v e a t t i t u d e s o f o t h e r s ( C o n n i d i s , 1987; Harvey e t a l . , 1987;  L a r s o n , 1978; M a r t i n Matthews, 1987; Matthews, 1986). The  women i n t h e study d i d n o t i d e n t i f y low income as a t h r e a t t o them p e r s o n a l l y , however they acknowledged t h a t t h e y were f o r t u n a t e t o have enough f i n a n c i a l r e s o u r c e s . The o t h e r t h r e a t s mentioned above a r e s i m i l a r t o those t h a t can t h r e a t e n t h e women's connectedness.  The women i n t h e study h e l p e d us t o  understand t h e impact o f these t h r e a t s more c l e a r l y . One  o f t h e t h r e a t s d i s c u s s e d by t h e p a r t i c i p a n t s i n t h i s  study was t h e conduct o f o t h e r s . Rodin and Langer conducted  (1980)  a number o f s t u d i e s which showed t h a t o t h e r people's  a t t i t u d e s and a c t i o n s c o u l d decrease t h e o l d e r person's  feeling  of c o n t r o l which i n t u r n reduced h i s o r h e r s e l f - e s t e e m . A reduced s e l f - e s t e e m c o u l d lower a person's a b i l i t y t o m a i n t a i n t h e i r independence and connectedness. The  f i n d i n g s o f t h i s study showed t h a t although people may  t h i n k t h a t they a r e a s s i s t i n g an o l d e r woman, they may i n f a c t be i n t e r f e r i n g w i t h h e r independence. Both t h e p u b l i s h e d r e s e a r c h s t u d i e s and t h e women i n t h i s study i d e n t i f i e d many s i m i l a r t h r e a t s . However, by g a i n i n g t h e women's p e r s p e c t i v e s , t h r e a t s were seen i n a l a r g e r c o n t e x t . The study showed t h a t t h e t h r e a t s i n t e r f e r e d w i t h t h e women's  63  independence and  connectedness and  t h r e a t s , by c a l l i n g upon t h e i r  the women c o u l d o f f s e t the  resources.  Resources Drawing upon resources  i s the t h i r d phase i n the c y c l e of  contentment. Information r e g a r d i n g  resources  tended t o  identify  f a c t o r s t h a t c o n t r i b u t e d t o the o l d e r person's s a t i s f a c t i o n well-being.  However, u n l i k e the c y c l e of contentment, many of  these s t u d i e s d i d not i d e n t i f y these f a c t o r s as r e s o u r c e s , c o n s e q u e n t l y they d i d not d i f f e r e n t i a t e between e x t e r n a l concrete  and  resources,  Good h e a l t h was  and  the more i n t a n g i b l e i n t e r n a l  and  or  resources.  i d e n t i f i e d i n s e v e r a l s t u d i e s as a major  contributor to well-being  (Connidis  1987;  Larson, 1978;  George &  Landerman, 1984). Other f a c t o r s i d e n t i f i e d i n c l u d e d adequate f i n a n c e s , s o c i a l support, f a m i l y support, and religion  (George & Landerman, 1984;  dependence upon  Harvey e t a l . , 1987;  Martin  Matthews, 1987). Lazarus and  Folkman (1984), c o n c e p t u a l i z e d  resources  manner s i m i l a r t o the c y c l e of contentment. These did  not b e l i e v e t h a t a person coped a c e r t a i n way  researchers because of  t h e i r p e r s o n a l i t y t r a i t s . They b e l i e v e d t h a t the way coped was  dependent upon how  the s i t u a t i o n was  person coping  and  of r e s o u r c e s .  They i d e n t i f i e d these resources  t h a t people coped b e t t e r i f they had  s o c i a l support and m a t e r i a l r e s o u r c e s "  by  the  a number  "health  energy,, e x i s t e n t i a l b e l i e f s , problem s o l v i n g s k i l l s , skills,  a person  perceived  as  in a  and  social  (p.179), a l l of  64 which are v e r y s i m i l a r t o those d e s c r i b e d i n the c y c l e of contentment. Other q u a l i t a t i v e s t u d i e s p r o v i d e d i n f o r m a t i o n r e g a r d i n g i n t e r n a l r e s o u r c e s (Coleman, 1986; al.,  1986;  Myerhoff,  C o n n i d i s , 1986;  Erikson et  1978). Perhaps q u a l i t a t i v e s t u d i e s are best  s u i t e d t o r e v e a l i n g i n n e r r e s o u r c e s because  these r e s o u r c e s are  d i f f i c u l t t o see and t h e r e f o r e must be i d e n t i f i e d by the o l d e r people themselves. In the E r i k s o n e t a l . ,  (1986) study,  people  d e s c r i b e d themselves as "more t o l e r a n t , more p a t i e n t , more openminded, more understanding, more compassionate  and l e s s  critical  than t h e y were when they were i n t h e i r younger y e a r s " (p. 60). These statements were s t r i k i n g l y s i m i l a r t o the ones i d e n t i f i e d i n the c y c l e of In  contentment.  a Canadian  study by C o n n i d i s (1987), o l d e r people  d e s c r i b e d l i k i n g t h e i r i n c r e a s e d p e r s o n a l freedom, reduced r e s p o n s i b i l i t i e s and enhanced s e l f - c o n f i d e n c e . A g a i n , these f i n d i n g s were noted i n the c y c l e of Few  contentment.  s t u d i e s acknowledged the f a c t t h a t women d i f f e r e n t i a t e d  between t h e i r a g i n g e x t e r n a l bodies and t h e i r a g e l e s s i n n e r s e l v e s . However, a grounded study by Kaufman (1986) found t h a t "when o l d people t a l k about themselves, they express a sense of s e l f t h a t i s a g e l e s s , an i d e n t i t y t h a t maintains  continuity  d e s p i t e the p h y s i c a l and s o c i a l changes t h a t come w i t h o l d age" (p.  7 ) . The c y c l e of contentment  f u r t h e r s our u n d e r s t a n d i n g of  t h i s f i n d i n g . I f o l d e r people are judged on a p h y s i c a l b a s i s a l o n e , t h e i r o t h e r c a p a b i l i t i e s and r e s o u r c e s may  be o v e r l o o k e d .  65 Although widowhood can be a time of g r i e f , t h i s study found t h a t a number of women i n c r e a s e d t h e i r s e l f c o n f i d e n c e r e s u l t of having  t o make t h e i r own d e c i s i o n s a f t e r they were  widowed. A study by M a r t i n Matthews (1987) concurred finding;  as a  with  this  i t concluded t h a t some widows g a i n a sense of  s a t i s f a c t i o n when they a r e able t o overcome t h e g r i e f of widowhood and move on t o f e e l i n g c o n f i d e n t about making t h e i r own d e c i s i o n s . Memories a r e another important resource c y c l e of contentment. Other q u a l i t a t i v e  i d e n t i f i e d i n the  studies highlight  the  importance of memories and r e m i n i s c i n g f o r t h e o l d e r person, but memories a r e not i d e n t i f i e d as resources  (Coleman, 1986;  E r i k s o n e t a l . , 1986; Myerhoff, 1978; Recker, Peacock & Wong, 1987). The E r i k s o n , e t a l . , (1986) study i n d i c a t e d t h a t memories c o u l d h e l p o l d e r people f u l f i l l t h e i r sense of i n t i m a c y by remembering t h e i r dead l o v e d ones. I t a l s o concluded t h a t memories and r e m i n i s c i n g c o u l d a s s i s t an o l d e r person t o s u c c e s s f u l l y r e e v a l u a t e and r e s o l v e past unachieved stages.  psychosocial  Myerhoff's study, (1978) f o c u s s i n g on o l d e r Jewish  people showed t h a t they used t h e i r memories t o h e l p them s t a y connected w i t h t h e i r p a s t and t o h e l p them c a r r y on t h e i r Jewish t r a d i t i o n s . Therefore, memories as a  these s t u d i e s supported t h e importance of  resource.  In g e n e r a l , t h e q u a l i t a t i v e  s t u d i e s i d e n t i f i e d a number of  f a c t o r s t h a t were s i m i l a r t o the i n t e r n a l r e s o u r c e s  outlined i n  the c y c l e of contentment. I f we can see these r e s o u r c e s  as p a r t  66 of a c y c l e , we can begin t o understand how they can be used t o meet t h e c h a l l e n g e s and t h r e a t s a s s o c i a t e d w i t h o l d age. R e d e f i n i n g Independence and Connectedness R e d e f i n i n g independence  and connectedness  phase i n t h e c y c l e o f contentment. completed  was t h e f o u r t h  The women i n t h i s  study  t h e f o u r t h phase i n t h r e e ways. They found new ways  t o e x p e r i e n c e independence  and connectedness,  they n o r m a l i z e d  the events o r changes t h a t they encountered r e g u l a r l y a t t h i s time i n t h e i r l i v e s , and they r e a p p r a i s e d t h e i r  situations.  Although t h e g e n e r a l l i t e r a t u r e d i d not use t h e t e r m i n o l o g y " r e d e f i n i n g independence revealed s i m i l a r  and connectedness,"  a number o f s t u d i e s  findings.  For example, o t h e r r e s e a r c h e r s have noted t h a t o l d e r people n o r m a l i z e d t h r e a t s i n t h a t they had g r e a t e r acceptance o f t h e i r own  death, and t h e death o f f r i e n d s and they r e c o g n i z e d t h a t  h e a l t h problems were i n e v i t a b l e w i t h i n c r e a s i n g age (Costa, Zonderman, McCrae, Cornoni-Huntley, & Barbano, 1986; Matthews, 1986;  Recker e t a l . ,  1987,). These s t u d i e s , however, p l a c e d more  emphasis on naming t h e t h r e a t s than showing how the people overcame t h e t h r e a t s . The c y c l e o f contentment  showed t h a t women  drew upon t h e i r r e s o u r c e s , e s p e c i a l l y t h e i r p e r s o n a l a t t r i b u t e s to normalize the threats. Other r e s e a r c h e r s have shown t h a t r e a p p r a i s i n g a s i t u a t i o n was al.,  an important process f o r o l d e r people. A study by Lohr e t (1988) found t h a t p o s i t i v e c o g n i t i v e c o p i n g , a form o f  r e a p p r a i s a l , was e f f e c t i v e f o r women who e x p e r i e n c e d many d e t e r i o r a t i n g p h y s i c a l c o n d i t i o n s . F o r these women, p o s i t i v e  67 comparisons w i t h peers and a focus on the good a s p e c t s of t h e i r h e a l t h h e l p e d them t o cope w i t h t h e i r p h y s i c a l c o n d i t i o n . Other r e s e a r c h e r s d e s c r i b e d the process of r e a p p r a i s i n g one's s i t u a t i o n as f i n d i n g a new match between a s p i r a t i o n l e v e l s abilities  (Fooken,  1981)  and  or t h i n k i n g about the whole of one's  l i f e r a t h e r than f o c u s s i n g on one p a r t i c u l a r a s p e c t  (George,  1986). Recent r e s e a r c h on coping processes has enhanced our u n d e r s t a n d i n g of the r e a p p r a i s a l aspect of the f i n d i n g s i n t h i s study. The r e s e a r c h i d e n t i f i e d two  forms of coping, emotion  f o c u s s e d and problem focussed. The  l i t e r a t u r e showed t h a t when a  person was  f a c e d w i t h a c h a l l e n g e o r a s i t u a t i o n t h a t cannot  changed, emotion-focussed  coping was  more e f f e c t i v e . I t  d i m i n i s h e d the t h r e a t by changing the meaning of the without changing  be  the o b j e c t i v e s i t u a t i o n  situation  (Lazarus & Folkman,  1985). In c h a l l e n g i n g s i t u a t i o n s t h a t can be changed, problemf o c u s s e d c o p i n g was  mOre e f f e c t i v e .  S c h e l t e r , D e l o n g i s & Gruen, 1986;  (Folkman, L a z a r u s ,  Dunkel-  Lazarus & Folkman, 1985).  The  l i t e r a t u r e emphasised d e f i n i n g the problem, g e n e r a t i n g a l t e r n a t i v e s o l u t i o n s and choosing the b e s t a l t e r n a t i v e  (Lazarus  & Folkman, 1985) . A study by Folkman, Lazarus, Pimley & Novacek (1987) examined age d i f f e r e n c e s i n r e l a t i o n t o s t r e s s and  coping  p r o c e s s e s . They found t h a t o l d e r people used p r o p o r t i o n a t e l y more p a s s i v e , i n t r a p e r s o n a l , emotion-focussed  forms of coping  ( d i s t a n c i n g , a c c e p t i n g r e s p o n s i b i l i t y and p o s i t i v e r e a p p r a i s a l ) than d i d younger people. However, o l d e r people used more  68 c o n f r o n t i v e coping i n h e a l t h encounters  than d i d younger  people  (p. 182). These f i n d i n g were c o n s i s t e n t w i t h t h e f i n d i n g s i n t h e c y c l e o f contentment. Many of t h e women used  emotion-focussed  forms o f c o p i n g when they were f a c e d w i t h s i t u a t i o n s t h a t c o u l d not be changed, and problem s o l v i n g coping when they f e l t t h a t a s i t u a t i o n c o u l d be changed. The women i n t h i s study r e c o g n i z e d t h a t c e r t a i n t h r e a t s were i r r e v e r s i b l e . They were wise enough t o know t h a t i f something c o u l d n o t be changed, t h e o n l y reasonable  t h i n g t o do  was t o r e a p p r a i s e t h e s i t u a t i o n s so t h a t they c o u l d r e t u r n t o contentment and g e t on w i t h t h e i r l i v e s . They were a b l e t o t u r n to  t h e i r unique combination  life,  of r e s o u r c e s , o f t e n a c q u i r e d l a t e i n  t h a t were e s p e c i a l l y s u i t e d i n a s s i s t i n g them t o cope w i t h  the t h r e a t s . Summary The study's The  f i r s t s e c t i o n o f chapter f i v e d e s c r i b e d how t h e f i n d i n g s answered two of t h e t h r e e r e s e a r c h  second s e c t i o n o u t l i n e d how t h e c o n c e p t u a l  on t h e n u r s i n g concept  questions.  framework, based  o f a c r i t i c a l p e r i o d , was u s e f u l i n  d i r e c t i n g t h e r e s e a r c h e r t o seek out t h e women's p e r s p e c t i v e and i n designing the research  questions.  In t h e t h i r d s e c t i o n of chapter f i v e , f i n d i n g s i n t h e c y c l e of  contentment were compared t o other r e s e a r c h f i n d i n g s .  Although  t h e l i t e r a t u r e d i d not d e s c r i b e t h e c y c l e o f  contentment, a number of r e s e a r c h s t u d i e s v a l i d a t e d t h e f i n d i n g s i n each phase of t h e c y c l e of contentment. The r e s u l t s from t h i s  69  study showed t h e r e l a t i o n s h i p between a number o f f a c t o r s t h a t many r e s e a r c h e r s have looked a t i n i s o l a t i o n . T h i s study  extends  our knowledge because i t c l e a r l y d e f i n e s each f a c t o r and then shows t h e l i n k a g e s between them. The c y c l e of contentment p r o v i d e d a window through which we can see how t h e e i g h t women i n t h e study p e r c e i v e d c e r t a i n a s p e c t s of t h e i r worlds. Through t h e c y c l e of contentment we l e a r n e d t h a t from t h e o u t s i d e l o o k i n g in-, t h e women may have appeared  o l d and f r a i l , b u t from t h e i n s i d e l o o k i n g out, they  d i d n o t see themselves  as such. Contentment was t h e form o f  happiness t h a t they p r e f e r r e d . Although they a r e c o n f r o n t e d by many t h r e a t s which c h a l l e n g e t h e i r contentment, t h e c y c l e o f contentment showed t h a t they possessed an unique r e p e r t o i r e of r e s o u r c e s . These r e s o u r c e s reduced t h e impact o f these t h r e a t s and h e l p e d them t o r e d e f i n e t h e i r independence and connectedness.  T h i s study has shown t h a t by s e e k i n g t h e women's  p e r s p e c t i v e s , we can see t h a t a p r e o c c u p a t i o n w i t h t h e i l l n e s s a s s o c i a t e d w i t h o l d age might c l o u d our v i s i o n o f t h e n a t u r a l n e s s o f o l d age and the s t r e n g t h and r e s o u r c e s t h a t these women p o s s e s s .  70 CHAPTER 6 SUMMARY, CONCLUSIONS AND IMPLICATIONS FOR- NURSING  Introduction T h i s study e x p l o r e d The  how o l d e r women p e r c e i v e t h e i r  lives.  demographic data show t h a t as t h e y e a r 2000 approaches, t h e  number o f o l d e r women l i v i n g on t h e i r own w i l l s t e a d i l y i n c r e a s e . O l d e r women a r e l i k e l y t o e x p e r i e n c e i n c r e a s i n g h e a l t h problems. T h e r e f o r e ,  nurses can expect t o come i n t o c o n t a c t  with  more and more o l d e r women, i n both i n s t i t u t i o n a l and community s e t t i n g s . A t present,  the information  a v a i l a b l e t o nurses about  o l d e r women i s p r i m a r i l y l i m i t e d t o d i s e a s e p r o c e s s e s . study evolved  from a need t o begin t o r e d r e s s  This  t h a t imbalance, t o  l e a r n more about o l d e r women i n g e n e r a l , but more s p e c i f i c a l l y t o understand how they p e r c e i v e t h e i r A l i t e r a t u r e search  revealed  lives.  few s t u d i e s  focussing  s p e c i f i c a l l y on o l d e r women. Of t h e s t u d i e s t h a t d i d e x i s t , most examined i n s t i t u t i o n a l i z e d o l d e r women i n poor h e a l t h . Widowhood studies provided concentrated  a d d i t i o n a l information,  but g e n e r a l l y  on t h e impact of t h e death of t h e husband. However,  the q u a l i t a t i v e s t u d i e s i n v o l v i n g both men and women d i d o f f e r i n s i g h t s i n t o h e a l t h , aging,  and t h e l i k e s and d i s l i k e s o f t h e  older c i t i z e n . Nevertheless,  t h e r e appeared t o be no s u b j e c t i v e  account o f women's experience o f aging.  T h i s study attempted t o  r e c t i f y that s i t u a t i o n . Phenomenology proved the most p r a c t i c a l method f o r conducting t h i s research;  i t i s an e f f e c t i v e way of g a i n i n g a  broad p e r s p e c t i v e about a l i t t l e - k n o w n r e s e a r c h t o p i c . Furthermore, because t h e aim of phenomenology i s "to understand the e x p e r i e n c e compatible The  as i t i s l i v e d "  w i t h t h e conceptual  (Omery, 1983, p.50), i t was framework t h a t guided  t h e study.  concept o f a c r i t i c a l p e r i o d from t h e UBC model f o r n u r s i n g  (1987) i d e n t i f i e d t h e importance of seeking t h e women's p e r s p e c t i v e s and was u s e f u l i n f o r m u l a t i n g t h e r e s e a r c h questions. The  r e s e a r c h e r r e c r u i t e d s u b j e c t s i n t h e study, who l i v e d  alone i n t h e community, through an i n f o r m a l network o f c o l l e a g u e s and f r i e n d s . The e i g h t women who p a r t i c i p a t e d were a l l widows and mothers. T h e i r ages ranged from 75 t o 88. I n t e n s i v e i n t e r v i e w s which were tape-recorded and subsequently  t r a n s c r i b e d p r o v i d e d t h e data f o r t h i s study.  Seven  p a r t i c i p a n t s were i n t e r v i e w e d t w i c e . One woman became i l l and was  unable t o p a r t i c i p a t e i n a second i n t e r v i e w . The  r e s e a r c h e r s e l e c t e d G i o r g i ' s (1975, 1985)  phenomenological method as a guide i n a n a l y z i n g t h e d a t a .  Within  the women's s t o r i e s , t h e r e s e a r c h e r i d e n t i f i e d t h e n a t u r a l meaning u n i t s . From these u n i t s e s s e n t i a l themes emerged. These themes were s y n t h e s i z e d and then i n t e g r a t e d i n t o a f i n a l framework c a l l e d t h e " c y c l e of contentment". Through t h i s framework i t was p o s s i b l e t o g a i n i n s i g h t i n t o how these women p e r c e i v e d t h e i r The  older  lives.  c y c l e o f contentment had f o u r phases:  independence and connectedness (the sources  having  o f contentment),  e x p e r i e n c i n g t h r e a t s , c a l l i n g upon r e s o u r c e s , and r e d e f i n i n g  72  independence and connectedness. Contentment i n t h i s c y c l e was described and  as a f e e l i n g s t a t e t h a t was c h a r a c t e r i z e d by calmness  freedom from u n e a s i n e s s . I t was these women's p r e f e r r e d form  of happiness. Independence and connectedness were two sources o f contentment. Independence was composed o f s e l f - r e l i a n c e , o f not h a v i n g t o inconvenience others events and p e r s o n a l  and of being  i n c o n t r o l of d a i l y  a f f a i r s . Connectedness, on t h e other  was  equated w i t h a sense o f belonging  and  being  hand,  w i t h f a m i l y and f r i e n d s ,  i n v o l v e d arid aware of what was happening i n t h e world.  Unfortunately,  t h e women found t h e i r independence and  connectedness e a s i l y d i s r u p t e d by t h r e a t s . T h r e a t s were experienced when a spouse o r f r i e n d s d i e d , when t h e r e were h e a l t h problems, and when t h e women were exposed t o t h e adverse a t t i t u d e s and a c t i o n s o f o t h e r s . U l t i m a t e l y t h e t h r e a t s c r e a t e d discontentment. In response t o discontentment the women made a c h o i c e about whether o r n o t t o draw upon t h e i r resources. There were two types of r e s o u r c e s : External resources  i n c l u d e d f i n a n c e s , f a m i l y , f r i e n d s and  n e i g h b o r s . I n t e r n a l resources confidence, resources  e x t e r n a l and i n t e r n a l .  i n c l u d e d f a i t h , memories, s e l f -  a f i g h t i n g s p i r i t and p e r s o n a l  attributes. Internal  were u s u a l l y i n t a n g i b l e and thus d i f f i c u l t  f o r an  o u t s i d e person t o i d e n t i f y . By drawing upon both types o f resources,  i t was p o s s i b l e f o r t h e women i n t h i s study t o move  t o t h e next phase o f t h e c y c l e , t h a t of r e d e f i n i n g independence and  connectedness.  73 T h i s r e d e f i n i t i o n took t h r e e paths: f i n d i n g new ways o f e x p e r i e n c i n g independence and connectedness, n o r m a l i z i n g t h e t h r e a t s t h a t o c c u r r e g u l a r l y i n o l d age and r e a p p r a i s i n g t h e s i t u a t i o n . Once independence and connectedness were r e d e f i n e d , contentment r e t u r n e d . T h i s study drew a number o f c o n c l u s i o n s : 1. Women over 70 e x p e r i e n c e l i f e d i f f e r e n t l y than t h e y d i d when they were younger. 2. Women do n o t c o n s i d e r themselves t o be o l d based on t h e i r c h r o n o l o g i c a l age a l o n e . 3. The women i n t h i s study p r e f e r contentment  over a more  e x c i t a b l e o r e u p h o r i c form o f happiness. 4. Two sources o f contentment a r e independence and connectedness. The meaning of independence and connectedness a r e s u b j e c t i v e l y determined. 5. The women's contentment  c o u l d be e a s i l y d i s r u p t e d by a number  of t h r e a t s i n c l u d i n g : t h e death o f a spouse and f r i e n d s , h e a l t h problems and t h e conduct o f o t h e r s when i t i n t e r f e r e s w i t h t h e i r independence and connectedness. 6. When contentment  i s l o s t i t can be r e g a i n e d i f t h e o l d e r  woman draws upon h e r r e s o u r c e s i n o r d e r t o r e d e f i n e and  independence  connectedness.  7. Women can have e x t e r n a l o r i n t e r n a l r e s o u r c e s . I n t e r n a l r e s o u r c e s a r e extremely v a l u a b l e , but s i n c e t h e y a r e i n t a n g i b l e , they a r e d i f f i c u l t  f o r an o u t s i d e person t o i d e n t i f y .  7. Women who a r e a b l e t o r e d e f i n e t h e i r independence and connectedness can r e t u r n t o contentment.  74  Nursing I m p l i c a t i o n s The  f i n d i n g s of the study suggest a number of i m p l i c a t i o n s  f o r n u r s i n g p r a c t i c e , n u r s i n g e d u c a t i o n , and n u r s i n g r e s e a r c h . The  f o l l o w i n g s e c t i o n p r e s e n t s these  I m p l i c a t i o n s f o r Nursing  implications.  Practice  The nurse can use the f i n d i n g s from the study i n each phase of the n u r s i n g p r o c e s s . As independence and connectedness important  are  sources of contentment, the nurse w i l l need t o assess  the woman's p e r c e i v e d l e v e l of independence and  connectedness.  I f the woman i s not content, the nurse should assess f o r the presence of t h r e a t s . The nurse can then determine  what r e s o u r c e s  the woman has a v a i l a b l e t o h e l p her o f f s e t the t h r e a t s . As i n t e r n a l r e s o u r c e s are d i f f i c u l t t o i d e n t i f y , the nurse r e c o g n i z e the importance  will  of spending time t a l k i n g w i t h the woman  i n o r d e r t o i d e n t i f y the r e s o u r c e s . In p l a n n i n g the c a r e , the nurse and the o l d e r woman i d e n t i f y t h a t some of the woman's r e s o u r c e s need For example, the woman may  may  supplementing.  want t o be d i s c h a r g e d home from  the  h o s p i t a l but because she has l i t t l e money and no f a m i l y support, the nurse may  i n v o l v e community agencies t o p r o v i d e the  a s s i s t a n c e t h a t the woman needs t o c o n t i n u e l i v i n g i n her home. The nurse may  independently  a l s o want t o i n c o r p o r a t e some of the  woman's r e s o u r c e s i n t o the n u r s i n g care p l a n . For i n s t a n c e , a woman who  has  j u s t l o s t her husband may  have many memories t h a t  would h e l p her work through the g r i e v i n g p r o c e s s , but she needs t o be a b l e t o t a l k about them. T h e r e f o r e , the nurse encourage the woman t o v e r b a l l y share her memories.  can  75  The nurse can a l s o h e l p the woman t o r e d e f i n e h e r independence and connectedness  by h e l p i n g h e r f i n d new ways o f  e x p e r i e n c i n g them. The nurse may encourage t h e woman t o a t t e n d a s e n i o r s ' day c a r e o r a s e n i o r s ' w e l l n e s s group. F i n a l l y , i n e v a l u a t i n g t h e n u r s i n g i n t e r v e n t i o n t h e nurse can determine  i f t h e woman p e r c e i v e s t h a t she has independence  and connectedness  and thus contentment. I f t h e woman does n o t  have contentment, then t h e nurse should reexamine each phase of the c y c l e o f contentment t o determine  where t h e woman i s i n t h i s  process. Next, t h i s study's f i n d i n g s show t h a t t h e a t t i t u d e s and r e s u l t i n g a c t i o n s o f o t h e r s can i n t e r f e r e w i t h a woman's independence and connectedness.  T h e r e f o r e , nurses  should  i d e n t i f y and examine t h e i r own b e l i e f s about and a t t i t u d e s toward o l d e r women. They should a l s o t r y and understand  more  about how t h e o l d e r woman p e r c e i v e s h e r l i f e . With t h i s i n f o r m a t i o n , t h e nurse can i d e n t i f y any b i a s e s t h a t c o u l d i n t e r f e r e with h i s o r her a b i l i t y t o d e l i v e r e f f e c t i v e nursing c a r e and b e g i n t o work i n c o l l a b o r a t i o n w i t h o l d e r women f o r goal s e t t i n g  purposes.  Health i s a valuable resource f o r the p a r t i c i p a n t s i n t h i s study. Although t h e women have a number o f h e a l t h problems, they focus on and take c a r e of t h e i r remaining good h e a l t h . T h e r e f o r e , nurses should focus not o n l y on t h e o l d e r woman's h e a l t h problems, b u t should a l s o h e l p these women t o m a i n t a i n and enhance t h e i r h e a l t h . The focus o f c a r e should be d i r e c t e d  76 towards both primary and secondary p r e v e n t i o n t h e r e b y e n a b l i n g the women t o m a i n t a i n t h e i r independence and connectedness. I m p l i c a t i o n s f o r Nursing Education Many o f t h e i m p l i c a t i o n s f o r n u r s i n g p r a c t i c e d i s c u s s e d i n the p r e v i o u s s e c t i o n a r e r e l e v a n t t o n u r s i n g e d u c a t i o n . T h i s study shows t h a t women over 70 can remain independent and i n v o l v e d w i t h l i f e . Although t h e women may be p h y s i c a l l y o l d and frail,  they do n o t see themselves  as o l d . T h e r e f o r e , i t may be  u s e f u l f o r n u r s i n g students t o have t h e i r f i r s t c o n t a c t w i t h h e a l t h y o l d e r women r a t h e r than i l l and d e b i l i t a t e d o l d e r female p a t i e n t s . T h i s c o n t a c t would enable students t o d i f f e r e n t i a t e between o l d age and i l l n e s s i n o l d age. The study demonstrates.the  importance  of seeking o l d e r  women's p e r s p e c t i v e s . Although t h e women e x p e r i e n c e a number of c h r o n i c h e a l t h problems they do not n e c e s s a r i l y c o n s i d e r themselves  t o be u n w e l l . They want t o have t h e i r independence  and connectedness.  T h e r e f o r e students c o u l d be taught t h a t when  they a r e d e a l i n g w i t h c h r o n i c i l l n e s s , t h e emphasis i s n o t on cure b u t on h e l p i n g the woman r e g a i n h e r independence and connectedness.  Only by o b t a i n i n g t h e women's p e r s p e c t i v e s can  the student determine whether t h e women have r e g a i n e d t h e i r independence and connectedness. Students can be taught t h e importance  of i d e n t i f y i n g t h e  women's i n t e r n a l r e s o u r c e s . T h i s study i d e n t i f i e s a number of i n t a n g i b l e i n n e r r e s o u r c e s t h a t may be p r e s e n t i n t h e o l d e r women. The students can use t h i s i n f o r m a t i o n when they a r e engaged i n a n u r s i n g assessment.  F i n a l l y , as t h e r e i s such an emphasis on youth i n our s o c i e t y , n u r s i n g s t u d e n t s , l i k e p r a c t i c i n g nurses, should i d e n t i f y t h e i r b e l i e f s about o l d women and p i c t u r e themselves i n t h a t p o s i t i o n . Then they must be taught how t o e l i c i t i n f o r m a t i o n from t h e o l d e r woman so t h a t they can understand how each o l d e r woman p e r c e i v e s h e r s e l f . From these e x p e r i e n c e s t h e s t u d e n t s can be taught t o r e c o g n i z e how t h e i r own b e l i e f s can i n f l u e n c e t h e i r d e l i v e r y of c a r e . Implications f o r Nursing  Research  T h i s study p r o v i d e s an i n i t i a l understanding o f how o l d e r women p e r c e i v e t h e i r l i v e s when they a r e over 70. I t a l s o h e l p s to  i d e n t i f y t h e need f o r more s t u d i e s . T h i s study e x p l o r e s one  group o f o l d e r women. F u r t h e r s t u d i e s a r e needed t h a t focus on women from d i f f e r e n t e t h n i c groups, d i f f e r e n t  socio-economic  l e v e l s , and women l i v i n g alone w i t h a v a r i e t y o f h e a l t h impairments. The c y c l e o f contentment has been i d e n t i f i e d and d e s c r i b e d ; however, each phase o f t h e c y c l e warrants  further  examination.  F o r example, t h i s study acknowledges t h e importance  of i n t e r n a l  r e s o u r c e s , b u t t h e ways these r e s o u r c e s can be r e c o g n i z e d and i n c o r p o r a t e d i n t o t h e n u r s i n g c a r e o f o l d e r women r e q u i r e s further research. Future s t u d i e s c o u l d i n c r e a s e t h e understanding o f discontentment. L o n g i t u d i n a l s t u d i e s would be u s e f u l t o g a i n i n s i g h t i n t o how t h e c y c l e repeats i t s e l f y e a r a f t e r year as t h e woman ages. They c o u l d p r o v i d e i n s i g h t i n t o why some women a r e unable t o r e t u r n t o contentment.  T h i s chapter concludes  the r e s e a r c h study. The f i n d i n g s  have been summarized. I m p l i c a t i o n s f o r n u r s i n g p r a c t i c e , e d u c a t i o n and r e s e a r c h were o u t l i n e d .  79 REFERENCES Baker, M. (1987). Aging i n Canadian s o c i e t y : A survey. Toronto, ON: McGraw-Hill Ryerson. B a r n e t t , R.C., & Baruch, G.K. (1978). Women i n t h e middle y e a r s : A c r i t i q u e o f r e s e a r c h and t h e o r y . Psychology of Women Q u a r t e r l y , 3. (2), 187-198. B r e y s t p r a a k , L. (1984). The development Boston, MA: L i t t l e , Brown.  of s e l f i n l a t e r years.  Burbank, P. (1986). P s y c h o s o c i a l t h e o r i e s o f a g i n g : A c r i t i c a l e v a l u a t i o n . Advances i n Nursing S c i e n c e , 8. (10), 73-86. Burdman, G. (1986). H e a l t h f u l a g i n g . Englewood C l i f f s , NJ: Prentice-Hall. B u r w e l l , E . J . (1984). Sexism i n s o c i a l r e s e a r c h on a g i n g . In J.M. V i c k e r s (Ed.), Taking sex i n t o account: The p o l i c y conseguences o f s e x i s t r e s e a r c h (pp. 185-208). Ottawa, ON: Carleton U n i v e r s i t y Press. Campbell, M. (1987). The UBC model f o r n u r s i n g : D i r e c t i o n s f o r n u r s i n g p r a c t i c e . Vancouver, BC: UBC School o f N u r s i n g . Canadian governmental r e p o r t on a g i n g . (1982). Ottawa, ON: Government o f Canada Chappel, N.L., S t r a i n , L.A. & B l a n d f o r d , A.A. (1986). Aging and h e a l t h c a r e : A s o c i a l p e r s p e c t i v e . Toronto, ON: H o l t , R i n e h a r t & Winston. Coleman, P.G. (1986). Ageing and r e m i n i s c e n c e p r o c e s s : S o c i a l and c l i n i c a l i m p l i c a t i o n s . New York: John W i l e y & Sons Costa, P., Zonderman, A., McCrae, R., Cornoni-Huntley, J . , Locke, B., & Barbano, H. (1987). J o u r n a l o f Gerontology, 42 ( 1 ) , 50-55. Cavan, R. S., Burgess, E.M., H a v i g h u r s t , R.J. & Goldhamer, H. (1949). P e r s o n a l adjustment i n o l d age. Chicago, I L : S c i e n c e Research A s s o c i a t i o n . Cohen, L. (1984). Small e x p e c t a t i o n s . Toronto, ON: M c C l e l l a n d & Stewart. C o n n i d i s , I . (1987). L i f e i n o l d e r age: A view from the t o p . In V.M. M a r s h a l l (Ed.), Aging i n Canada: S o c i a l p e r s p e c t i v e s (2nd ed., pp.451-472). Markham, ON: F i t z h e n r y & W h i t e s i d e . Cumming, E. & Henry, W.E. (1961). Growing o l d : The p r o c e s s o f disengagement. New York: B a s i c Books.  80 Doress, P.B. & S i e g e l , D.L. (1987). O u r s e l v e s , growing New York: Simon & Schuster. D u f f y , M.E. (1985). The q u a l i t a t i v e - q u a n t i t a t i v e J o u r n a l o f Advanced Nursing, 10., 225-232.  older.  debate.  E i c h l e r , M. & L a p o i n t e , J . (1985). On the treatment o f t h e sexes i n r e s e a r c h . Ottawa, ON: M i n i s t e r o f Supply and Service. E i c h l e r , M. (1980). The double standard. London: Croon Helm. E i c h l e r , M. (1983). Sexism i n r e s e a r c h and i t s p o l i c y i m p l i c a t i o n s . Ottawa, ON: Canadian Research I n s t i t u t e f o r the Advancement o f Women. E r i k s o n , E., E r i k s o n , J . & K i v n i k , H. (1986). V i t a l i n o l d age. New York: W.W. Norton.  involvement  F e n n e l l , G., P h i l l i p s o n , C. & Evers, H. (1988). The s o c i o l o g y o f o l d age• P h i l a d e l p h i a , PA: Open U n i v e r s i t y P r e s s . F i e l d , P.A. & Morse, J.M. (1985). N u r s i n g r e s e a r c h : The a p p l i c a t i o n o f Q u a l i t a t i v e approaches. R o c k v i l l e , MD: Aspen Systems. Folkman, S., L a z a r u s , R., Pimley, S. & Novacek, J . (1987). Age d i f f e r e n c e s i n s t r e s s and c o p i n g p r o c e s s e s . Psychology and Aging, 2 ( 2 ) , 171-184. Folkman, S., L a z a r u s , R., Dunkel-Schetter, C , DeLongis, A., & Gruen, R. (1986). Dynamics o f a s t r e s s f u l encounter: C o g n i t i v e a p p r a i s a l , coping, and encounter outcomes. J o u r n a l o f P e r s o n a l i t y and S o c i a l Psychology, 50 ( 5 ) , 9921003. Fooken, I . (1981). Old and female: P s y c h o l o g i c a l concomitants o f the a g i n g process i n a group o f o l d e r women. In J . Munnicks, P. Mussen, E. O l b r i c h , & P. Coleman ( E d s . ) , L i f e span and changes i n a g e r o n t o l o g i c a l p e r s p e c t i v e (pp. 77101). NY: Academic P r e s s . Funk & Wagnall's Canadian c o l l e g e d i c t i o n a r y (Revised and updated e d . ) . (1989). Toronto, ON: F i t z h e n r y & Whiteside. Gee,  E.M. & K i m b a l l , M.M. (1987). Women and a g i n g . Toronto, ON: Butterworths.  George, L., (1986). L i f e s a t i s f a c t i o n i n l a t e r G e n e r a t i o n s , 10 ( 3 ) , 5-9.  life.  81 George, L., & Landerman, R. (1984). H e a l t h and s u b j e c t i v e w e l l b e i n g : A r e p l i c a t e d secondary data a n a l y s i s . I n t e r n a t i o n a l J o u r n a l o f Aging and Human Development, 19 ( 2 ) , 133-156. G i l l i g a n , C. (1982). In a d i f f e r e n t v o i c e . Cambridge, MA: Harvard U n i v e r s i t y P r e s s . G i o r g i , A., F i s c h e r , C. & Murray, E. (1975). Duguesne s t u d i e s i n phenomenological psychology. V o l . 2. P i t t s b u r g h , PA: Duquesne U n i v e r s i t y P r e s s . G i o r g i , A. (1985). Phenomenology and p s y c h o l o g i c a l r e s e a r c h . P i t t s b u r g h , PA: Duquesne U n i v e r s i t y P r e s s . G o l a n t , S.M. (1975). Book review o f t h e myth o f t h e golden y e a r s . American J o u r n a l of S o c i o l o g y , 80 ( 4 ) , 1081-1083. Gooding, B., S l o a n , M., & Amsel, R. (1988). The w e l l - b e i n g of o l d e r Canadians. Canadian J o u r n a l o f N u r s i n g Research, 20 (2), 5-18. G r i f f i t h - K e n n e y , J . (1986). Contemporary women's h e a l t h . Menlo Park, CA: Addisonr-Wesley. Gubrium, J . F. (1973). The myth o f t h e golden y e a r s : A socio-environmental theory of aging. S p r i n g f i e l d , IL: C h a r l e s Thomas. Harvey, C.D.H., Barnes, G.E., Greenwood, L . J . , & KabahendaNyakabwa, R. (1987). A c t i v i t i e s , r e l i g i o s i t y , and morale of Canadian widowed persons. In H.Z. Lopata (Ed.), Widows: V o l . 2. (pp. 251-272). Durham, NC: Duke U n i v e r s i t y P r e s s . H a v i g h u r s t , R.J., & A l b r e c h t , R. (1953). O l d e r p e o p l e . New York: Longmans, Green. Hees, G. (1987). Elements o f t h e s e n i o r s ' i n i t i a t i v e s . Ottawa, ON: H e a l t h S e r v i c e s and Promotion Branch. Katzen, F.P. (1954). Book review o f o l d e r p e o p l e . S o c i a l S e r v i c e Review, 28 ( 2 ) , 231-233. Kaufman, S.K. (1986)^ The a g e l e s s s e l f : Sources of meaning i n l a t e l i f e . Madison, WI: U n i v e r s i t y o f W i s c o n s i n P r e s s . Knaack, P. (1984). Phenomenological r e s e a r c h . The Western J o u r n a l o f N u r s i n g Research. 6. ( 1 ) , 107-114. L a r s o n , R. (1978). T h i r t y years of r e s e a r c h on t h e s u b j e c t i v e w e l l - b e i n g o f o l d e r Americans. J o u r n a l o f Gerontology, 33 (1), 109-125.  82 L a z a r u s , R., & Folkman, S. (1984). S t r e s s , a p p r a i s a l and c o p i n g . New York: S p r i n g e r . Lohr, M.J., Essex, M., & K l e i n , M. (1988). The r e l a t i o n s h i p o f c o p i n g responses t o p h y s i c a l h e a l t h s t a t u s and l i f e s a t i s f a c t i o n among o l d e r women. J o u r n a l of Gerontology, 43 (2), 54-60. M a r t i n Matthews, A., (1987). Widowhood as an e x p e c t a b l e l i f e event. In V . M a r s h a l l (Ed.), Aging i n Canada: S o c i a l P e r s p e c t i v e s (2nd ed.) (pp.343-366). Markham, ON: F i t z h e n r y & Whiteside. Matthews, S. (1979). The s o c i a l world o f o l d women: Management of s e l f - i d e n t i t y . B e v e r l y H i l l s , CA: Sage P u b l i c a t i o n s . Matthews, S. (19 8 6 ) . F r i e n d s h i p s through t h e l i f e c o u r s e : O r a l b i o g r a p h i e s i n o l d age. B e v e r l y H i l l s , CA: Sage. Maxwell, E.K. (1988). S t a t u s d i f f e r e n c e s i n c o h o r t s o f a g i n g women. H e a l t h Care f o r Women I n t e r n a t i o n a l , 9., 83-91. Morse, J.M. (1986). Q u a l i t a t i v e and q u a n t i t a t i v e r e s e a r c h : Issues i n sampling. In P.L. Chinn (Ed.), N u r s i n g r e s e a r c h methodology: Issues and implementation (pp.181-189). R o c k v i l l e , MD: Aspen. Myerhoff, B. (1978). Number our days. New York: Simon & Schuster. Neugarten, B., H a v i g h u r s t , R. & T o b i n , S. (1968). P e r s o n a l i t y and p a t t e r n s o f aging i n middle age and a g i n g . In B. Neugarten (Ed.), Middle age and a g i n g (pp.173-177). Chicago, I L : U n i v e r s i t y p r e s s . O i l e r , C.J. (1986). Phenomenology: The method. In L. Munhall & C.J. O i l e r ( E d s . ) , Nursing Research a Q u a l i t a t i v e P e r s p e c t i v e (pp. 70-81). Norwalk, CT: P r e n t i c e H a l l . Omery, A. (1983) Phenomenology: A method f o r n u r s i n g r e s e a r c h . Advances i n N u r s i n g S c i e n c e , 5. ( 2 ) , 49-63. P a n i c u c c i , C.L. (1983). F u n c t i o n a l assessment o f t h e o l d e r a d u l t i n t h e acute c a r e s e t t i n g . N u r s i n g C l i n i c s o f North America, 18 ( 2 ) , 335-363. Reker, G.T., Peacock, E., & Wong, P. (1987). Meaning and purpose i n l i f e and w e l l - b e i n g : A l i f e span p e r s p e c t i v e . J o u r n a l o f Gerontology, 42 ( 1 ) , 44-49. R i s t , R.C. (1979, Summer). On t h e means of knowing: Q u a l i t a t i v e r e s e a r c h i n e d u c a t i o n . New York U n i v e r s i t y Q u a r t e r l y , 1721.  83 Robinson, K. (1986). O l d e r women: A l i t e r a t u r e review. J o u r n a l of Advanced N u r s i n g , 11, 153-160. Rodin, J . and Langer, E. (1980). Aging l a b e l s : The d e c l i n e of c o n t r o l and f a l l o f s e l f - e s t e e m . J o u r n a l o f S o c i a l S c i e n c e s , 36. ( 2 ) , 13-29. Ryder, N.B. (1985). The cohort as a concept o f t h e study of s o c i a l change. In V.M. Mason & S.E. Rienberg (Eds.), Cohort a n a l y s i s i n s o c i a l r e s e a r c h : Beyond t h e i d e n t i f i c a t i o n problem (pp.9-44). New York: S p r i n g e r Verlag. Parse, R.R., Coyne, B.A. & Smith, M.J. (1985). N u r s i n g r e s e a r c h : Q u a l i t a t i v e methods. Bowie, MD: Brady Communications. Sandelowski, M. (1986). The problem of r i g o u r i n q u a l i t a t i v e r e s e a r c h . Advances i n Nursing S c i e n c e , 8. ( 3 ) , 27-37. S a r t o n , M. (1987). A t seventy: A j o u r n a l . New York: W.W.  Norton.  Stone, L.O. & F l e t c h e r , S. (1986). The s e n i o r s ' boom: Dramatic i n c r e a s e s i n l o n g e v i t y and p r o s p e c t s f o r b e t t e r h e a l t h . Ottawa, ON: M i n i s t r y o f Supply and S e r v i c e s . Thorne, S., G r i f f i n , C. & A d l e r s b e r g , M. (1985). How's your h e a l t h ? W e l l s e n i o r s ' p e r c e p t i o n o f t h e i r h e a l t h and w e l l b e i n g . G e r o n t i o n , 5., 15-18. Washbourn, P. (1977). Becoming woman: The guest f o r wholeness i n female e x p e r i e n c e . New York: Harper & Row. World H e a l t h O r g a n i z a t i o n . (1986). Ottawa c h a r t e r f o r h e a l t h promotion. Canadian J o u r n a l o f P u b l i c H e a l t h , 77, 425-427.  84 APPENDICES  88 APPENDIX C SAMPLE TRIGGER QUESTIONS FOR THE INITIAL INTERVIEW 1. When you were younger, what d i d you t h i n k i t would be l i k e t o grow o l d ? 2.  Is growing o l d s i m i l a r t o what you thought i t would be?  3. What do you l i k e about being your age o r what do you c o n s i d e r the g a i n s o f b e i n g your age? 4. What do you d i s l i k e about being your age o r what do you c o n s i d e r t o be t h e l o s s e s a s s o c i a t e d w i t h your age? 5 . What i n f o r m a t i o n would you l i k e t o have had about growing o l d e r when you were young? 6 What would you l i k e h e a l t h p r o f e s s i o n a l s t o know about growing older?  

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