It is increasingly acknowledged that the quality of elders’ life is as important as to living longer
It is increasingly acknowledged that the quality of elders’ life is as important as to living longer. Since aging is typically associated with reduced capabilities and increased dependence, which may affect elders’ well-being (Jonker, Comijs, Knipscheer & Deeg, 2009), well-being in elderly is an area of great research interest for successful aging.
Social networks and elders’ well-being
Social networks are the most commonly investigated factors of successful aging. Numerous studies have found a positive relationship between social support (either from friends or family) and the well-being of older adults (Litwin; Shiovitz-Ezra, 2011; Nguyen, Chatters, Taylor, ; Mouzon, 2017 ). On the other hand, isolation or loneliness, which is conceptualized as the lack or poor social networks and support, both have been found to have a detrimental role on health and well-being (e.g., Courtin ; Knapp, 2017).
Whereas the association between social networks and well-being is well established, the importance of specific sources (spouses, children, relatives, and friends) is not; (Lee ; Szinovacz, 2016). Pinquart and Sorensen (2000) meta-analyzed 286 studies and argued about the higher importance of contact with friends over contact with adult children in the psychological well-being (PWB) among elders. However, when the quality of contacts was taken into account, contact with adult children, rather than friends, was associated with life satisfaction. Similarly, Chao (2012) found significant associations between PWB of elders in Taiwan with the instrumental support from family and the emotional support from both families and friends. Lee ; Szinovacz (2016) have also found that, positive interactions have a positive impact upon elders’ mental health and conversely (i.e., negative or ambivalent interactions have a negative impact on depressive symptoms) and these findings are more important for relationships with spouses and children than with friends. These findings imply that the qualitative aspects of social networks might be source specific.
Relatively few studies have investigated the association between life satisfaction/well-being and intergenerational relationships in older age. Family solidarity (Lowenstein, 2007) and emotional closeness in the intergenerational relationships within the family (Wu, Kasearu, Värnik, Tooding, & Trommsdorff, 2016) are both aspects of positive intrafamilial relationships and have been found to impact positively on elders’ quality of life and older mothers’ life satisfaction, respectively. Conversely, avoiding negative aspects of close relationships has been found to relate with better quality of life (Liao & Brunner, 2016). Thus, it has been argued that the qualitative aspects (i.e., subjective closeness, negative relationships) of family support are important predictors of well-being in old age, far beyond the structural ones (i.e., frequency of contact) (Nguyen, et al., 2017), or life conditions (Herrera, Fernández, & Barros, 2016).Therefore, we hypothesised that family support might has a stronger association with psychological well-being, than friend support. Moreover, negative aspects of close relationships might have more impact upon the elders’ well-being.
Family relationships and the Greek cultural context
There is abundant research indicating that the importance of family support is also culture specific. Family is considered an important value in the Southern European countries (Deng et al. 2010; Pulin et al, 2012), and adults are considered the main source of instrumental support for older people in Europe (Albertini, Kohli, ; Vogel, 2007). Familism refers to the ‘strong identification and attachment of individuals with their families (nuclear and extended), and strong feelings of loyalty, reciprocity and solidarity among members of the same family’ (Sabogal et al., 1987, pp. 397–398). Familial solidarity and filial piety are integral part of Greek familism values too (Karagiannaki, 2011; Djundeva, Mills, Wittek, ; Steverink, 2015).
Traditionally, in Greece elders depend heavily on family members for care and support. The endorsement of filial responsibility suggests that adult children, particularly the daughters and the oldest ones, are expected to take care for their elderly parents and make no use of formal services which is considered a shameful option for the family. Even though there is some evidence that this is progressively changing, in Greece the care and support is being provided nearly exclusively by the family (Karagiannaki, 2011). The economic crisis from which Greece has been severely affected has resulted in limited state and community resources available for the elderly which, in turn, has made the care of the elderly by the family a necessity.
Considering the cultural values in Greece, the negative interactions with the oldest child may be more important for elders’ PWB than positive ones with either the child or other family members. To authors’ knowledge there is no study examining the potential role of negative relating with the oldest child in the well-being among aging population within the Greek context.
The Relating Theory
A theory to describe and measure the quality of interpersonal relationships between parents and children is Relating theory (Birtchnell, 1993/1996). It resembles the Leary’s (1957) interpersonal theory, but it differs in many ways, which have been provided in detail elsewhere (Birtchnell, 2016). The theory defines relating as a person’s attitude and behaviour towards other people or a specified person, and interrelating as the relating which takes place between two specified people. It proposes that there are four states of relatedness; closeness (i.e., being involved) and distance (i.e., being separate) are depicted as the poles of a horizontal axis and upperness (i.e., relating from a relatively upper position) and lowerness (i.e., relating from a relatively lower position) are depicted as the poles of a vertical axis.. Between the four main poles, four intermediate ones can be inserted, each representing a mixture of the relating characteristics of the poles to either side of it: upper close, lower close, upper distant and lower distant. Together, these eight positions constitute a theoretical structure that is called the interpersonal octagon (see Figure 1). The theory also proposes that people being competent, confident, inoffensive, considerate and effective in relating in these poles are characterized by positive relating, which results in harmony in relationships. That which falls short of these competences is described as negative relating and results in disharmony in relationships. Typical examples of both positive and negative forms of relating across the eight positions of the octagon have been fully defined elsewhere (e.g., Birtchnell, 1993/1996) and are summarised in Figure 1.
Interrelating can be measured both by each person’s relating behavior towards a person and by each person’s view of the other’s relating behavior towards him/her.Thus there is a set of four questionnaires for assessing any given dyad, each of which has eight scales for measuring the eight positions of the octagon. The Family Members Interrelating Questionnaires (FMIQ) was designed to assess families’ negative interrelating across the eight positions of the octagon (see measures section).
Well-being and resilience
Resilience refers to the individual’s ability to achieve and maintain physical and mental well-being despite stressors and other age-related challenges (Young, Frick, & Phelan, 2009). Although resilience has been identified as one of many factors contributing to successful aging, there is far less research on its potential effects in elders’ well-being and no such studies in Greece. Relevant studies have shown that higher levels of resilience are linked to longevity (Zeng ; Shen, 2010; Wagnild, 2003), better mental and physical health (e.g, lower levels of depressive symptomatology and chronic pain) (Shure et al., 2013), better quality of life (Fontes, ; Neri, 2015), and higher well-being (Tomás, Sancho, Melendez, ; Mayordomo, 2012; van Kessel, 2013). Resilience has been reported to be closely associated with social support; higher social support positively associates with higher resilience in older ages (Lamond et al., 2008) and resilience has an indirect effect in the impact of social support on health-related quality of life among rural Chinese elders in nursing homes (Wu et al, 2017).
In conclusion, since (a) social support impacts on well-being and (b) resilience is associated with social support, and (c) resilience impacts well-being, then it seems reasonable to assume that resilience may play a mediating role in the relationship between social support/relationships and well-being.
This study aims to examine the effect of both positive and negative aspects of social relationships from diverse sources (partners, friends, and children) in predicting the well-being among Greek older community-dwellings, and also the potential mediating role of resilience. To authors’ knowledge no one study has investigated both the positive and negative role of different sources of social support (i.e., family, friends, and children) on elders’ SWB, particularly in Greece. Neither have studies examined the mediating role of resilience in the association of social relationships and well-being in this population.
In the present study the FMIQ was used to measure both the positive and negative interrelating between the elder parents and their child, from the parents’ view. It has the advantage of measuring both the self-assessed relating and the perceived or other-assessed relating. There is no such instrument to assess the relationship with friends and family, so the Significant Others Scale was used to measure positive aspects of support from husbands/wives and friends.
Based on the literature review and the familial values in Greece, the following hypotheses were examined among a sample of Greek community elder dwellings: (1) social support (i.e., family and friends support and relating with the oldest child) will correlate and be significant predictors of elders’ SWB, far beyond other health-related or sociodemographic variables; (2) social support from family (i.e., partners) will be more significant than friends support in predicting elders’ SWB; (3) negative relating (NR) with the oldest child rather than positive relating the child or with the partners will be more significant in predicting elders’ SWB; (4) resilience will potentially mediate the association between elders’ NR with the oldest child and their SWB. As further refinements of the study, the differences between how elder parents relate to the oldest child and how they consider that the oldest child relates to them were examined.