Independence and older American women: a concept exploration and analysis

Abstract

Thesis (Ph. D.)--University of Washington, 2000The goal of many public and private programs in the U.S. is to help older Americans maintain their independence. Assessments of independence are sometimes reduced to a single outcome: living alone. There is no consensus in the literature as to the meaning of independence for older adults, making it difficult to assess or measure the intent or outcome of such programs. Review of the literature suggests that actual or perceived independence is influenced by historical and cultural factors, as well as physical, cognitive, psychological, social, spiritual and economic resources. Given the increased risk of chronic illness, disability, and poverty faced by older women in the U.S., it is hypothesized that older women are more at risk for loss of (or less) independence than older men, and that subgroups of older women face more of this risk. Using data from the Second Supplement on Aging, exploratory factor analysis was used (a) to identify major components of independence and compare independence factors between men and women, and among subgroups based on age, race, ethnicity, marital status, living arrangement and income, (b) determine the extent to which living arrangement is a proxy for independence, and (c) develop a working definition of independence based on the preliminary results. Major components of independence are physical function, social ability, and physical health. The strongest predictors of physical function are sex and age. Males have significantly higher scores than females, and physical function declines with age. Predictors of social ability are sex, age, race, ethnicity, living arrangement and income, although limitations in the data set may have introduced bias in assessing the effect of race and ethnicity on social ability. Physical health scores did not significantly differ by sex and age; marital status and income are significant predictors of poorer physical health. There is partial support for the assumption that living alone is a proxy for independence. Those who live alone have significantly higher scores on social ability that those with other living arrangements, but no significant differences on physical function or health. A working definition of independence is provided based on this preliminary model