SUCCESSFUL AGING FOR SLAVIC ELDERLY IMMIGRANTS AND REFUGEES
IN SACRAMENTO COUNTY
Ilona Timofey
B.A., California State University, Sacramento 2009
PROJECT
Submitted in partial satisfaction of
the requirements for the degree of
MASTER OF SOCIAL WORK
at
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
SPRING
2011
SUCCESSFUL AGING FOR SLAVIC ELDERLY IMMIGRANTS AND REFUGEES
IN SACRAMENTO COUNTY
A Project
by
Ilona Timofey
Approved by:
___________________________, Committee Chair
Francis Yuen, DSW
____________________________
Date
ii
Student: Ilona Timofey
I certify that this student has met the requirements for format contained in the University
format manual, and that this project is suitable for shelving in the Library and credit is to
be awarded for the project.
, Graduate Coordinator
Teiahsha Bankhead, Ph.D., LCSW
________________
Date
Division of Social Work
iii
Abstract
of
SUCCESSFUL AGING FOR SLAVIC ELDERLY IMMIGRANTS AND REFUGEES
IN SACRAMENTO COUNTY
by
Ilona Timofey
This study examined older Slavic immigrant’s perceptions of the characteristics and
components of successful aging in America. Study data was collected through an
interview survey of 17 over 60 years old Slavic immigrant elderly individuals who live in
Sacramento County- in 2011. Findings indicated that successful aging involves family
functioning, sense of security and stability, coping with changes, and religious freedom.
Within these themes, subthemes of engaging with friends, helping others, acceptance, and
maintaining a positive attitude emerged as important components of aging successfully.
Implications for the design and delivery of programs for Slavic senior adults are
discussed.
_______________________, Committee Chair
Francis Yuen, DSW
_______________________
Date
iv
ACKNOWLEDGMENTS
I am grateful for the support of my caring husband Aleksandr Timofey, his prayers,
interest, and encouragement, and most of all his love and patience that have sustained me
during this process. The countless prayers of my family, friends, and the endless support
of my two mothers will not be forgotten as I celebrate the achievement of my graduate
degree. I could not have finished this project without their support. I would also like to
thank all of the Russian immigrants who participated in this project and shared their
personal stories. I would also like to express my appreciation and respect to Professor
Francis Yuen. I will always be grateful for his encouragement, support, and knowledge.
Above all, God receives all the praise for the completion of this part of my journey.
v
TABLE OF CONTENTS
Page
Acknowledgments……………………………………………………………………………v
Chapter
1. THE PROBLEM……………… …………………………………………………………1
Background of the Problem………………………………………………………...3
Statement of the Research Problem………………………………………………..7
Purpose of the Study………………………………………………………………...8
Research Question…………………………………………………………………...8
Definition of Terms………………………………………………………………… 8
Assumptions………………………………………………………………………….9
Justification………………………………………………………………………….10
Delimitation………………………………………………………………………....10
2. REVIEW OF THE LITERATURE…………………………………………………....12
Demographic Facts about Aging in America…………………………………….13
Definitions of Age…………………………………………………………………. 14
Conditions of Aging………………………………………………………………. 15
Measuring Successful Aging……………………………………………………….17
Slavic Elderly Immigrants and Refugees………………………………………….24
Psychological and Social Issues…………………………………………………....26
Intergenerational Issues and Family Caregiving………………………………… 27
vi
Physical and Mental Health Status……………………………………………….. 29
Theoretical Framework…………………………………………………………… 31
Summary………………………………………………………………………….... 32
3. METHODOLOGY……………………………………………………………………... 34
Research Design……………………………………………………………………. 34
Variables……………………………………………………………………………. 34
Participants……………………………………………………………………….…..36
Instrumentation……………………………………………………………………. ..36
Data Gathering Procedures………………………………………………………....37
Protection of Human Subjects…………………………………………………….. 38
Data Analysis………………………………………………………………………. 39
4. DATA ANALYSIS AND STUDY FINDINGS…………………………………….... 40
Descriptive Findings of Socio-demographic Variables………………………… .40
Specific Findings……………………………………………………………………. 41
Themes of Successful Aging………………………………………………………..44
Family Functioning…………………………………………………………………. 44
Security and Stability………………………………………………………………...45
Coping with Changes………………………………………………………………...46
Religious Freedom………………………………………………………………….. 46
Unique Findings……………………………………………………………………...47
Summary……………………………………………………………………………...47
vii
5.
CONCLUSIONS....................................................................................................... 49
Conclusions………………………………………………………………………… 49
Implications…………………………………………………………………………..51
Limitations………………………………………………………………………….. 52
Recommendations…………………………………………………………………...52
Appendix A. Informed Consent Form…………………………………………………55
Appendix B. Successful Aging Questionnaire …………………………………………...58
Appendix C. Interview Guide……………………………………………………………….62
References…………………………………………………………………………………….64
viii
1
Chapter 1
THE PROBLEM
All human beings share the common experience of growing older. Some confront
the reality of growing old by denial and some by holding to characteristics and behaviors
considered youthful. Others accept the aging process, with its inevitable changes.
Regardless of our feelings, whether we are 19 or 90, we continue to age as time passes.
This process begins at the moment of conception and continues until death. It is usually a
gradual process, hardly noticed by close associates.
Aging has many aspects but there are three major categories: biological,
psychological, and social. Biological aging refers to progressive anatomical and
physiological changes that take place in cells, organs, and systems of the body over time
(Neuhaus & Neuhaus, 1992).
Psychological aging refers to age-related changes in behavior that reflect the
person’s level of maturity and ability to adapt and cope successfully with the stresses in
life. Attitudes toward new experiences, flexibility regarding change, and curiosity about
experiences are some attributes that contribute to the impression of a person’s
psychological age. According to Neuhaus and Neuhaus (1992) psychological age is
measured in terms of how a person responds to life. They note that the psychologically
young expect to continue to feel and experience life in a vital manner.
Social aging refers to age-related change in an individual or group resulting from
defined roles or other social forces. The factor that makes aging most difficult in human
society arises from social aging because of the role that society imposes on people as they
2
reach a particular chronological point in life. Research shows that mainly the mental and
attitudinal changes in “old” people are not the result of biological effects but of roleplaying (Neuhaus & Neuhaus, 1992).
Erik Erikson is one of the first psychologists to concentrate on the later stages of
human development. Erikson formulated eight stages of ego development, from infancy
to old age; each stage represents a choice or a crisis for the expending ego (McPherson,
1983). Since the concern is with old age, this paper will discuss only the last two stages
in Erikson’s scheme, even though each involves the issues and builds on the strengths of
the earlier states.
The seventh stage of life, which Erikson sees as occurring in later maturity, is the
probably the longest stage of life. The struggle is between a sense of “generativity and the
sense of stagnation”. Generativity is an essential stage in psychosexual and psychosocial
development. When adults fail to accomplish this stage, they reflect a need for “pseudointimacy,” often in atmosphere of stagnation. Individuals then seem to become selfindulgent, and as Erikson notes, physical and emotional invalids. Erikson believes that
only when someone has adapted to the successes and disappointments of the preceding
stages can experience the fruition of the final stage of development (Neuhaus & Neuhaus,
1992; McPherson, 1983; Friedrich, 2001).
According to Erikson’s psychological theory of life span development, the life
stage age 60 and older was indicated as the final stage out of eight, and the crisis involved
late life is described as “integrity versus despair” (Neuhaus & Neuhaus, 1992, p.11).
Erikson believed that the crucial task during this stage is to evaluate one’s life and
3
accomplishments and affirm life as having been and continuing to be meaningful and
purposeful with the psychosocial issue of growing old with integrity in the face of death
(Friedrich, 2001). In Erikson’s life cycle theory, integrating was emphasized as a very
significant process for an individual at the last stage, and it was believed that the more
successfully a person has achieved a sense of integrity with wisdom, the more
appreciative and satisfied the person is with his past, present, and future (Neuhaus &
Neuhaus, 1992). Baltes and Baltes (1990, as cited in Friedrich, 2001, p. 152) in their
work with personality development and aging claim that “achieving generativity and
wisdom, becomes the yardstick for successful aging.” Other general yardsticks for
successful aging in later adulthood, based on Baltes and Baltes, include stability of
physical functioning and avoidance of chronic disabilities, stability of psychological
well-being and avoidance of mental illness, continued social networking, and
development of new relationships.
This research will focus on successful aging among Slavic elderly immigrants,
Russian-speaking immigrant elders who have been through peculiar life experiences,
especially a lot of changes in external environment as immigrants in the United States.
Background of the Problem
Slavic immigrant elderly. A tremendously increasing group of people over 65 sees
coming to the twenty-first century as one of its greatest challenges (Ron, 2007). In 1994,
one in eight Americans was 65 years of age or older (Friedrich, 2001). In 2030, one in
five will be in that age group. A significant increase in the number of those 65 years of
age and older will occur during 2010-2010, as the baby boomers will be entering the
4
elderly category (Friedrich, 2001). As the older population has increased in the United
States, in recent years another obvious phenomenon took place, immigration. Immigrants
from the former Soviet Union were among the largest groups to settle in the United
States during the 1990s (Hoffman et al., 2006). Recent Slavic immigrants to the United
States differ in several ways from earlier waves of immigrants leaving the former Soviet
Union. Prior to the 1970s, many immigrants from the former Soviet Union to the United
States, and all immigrants to Israel, were Jewish immigrants seeking freedom from
religious prosecution and human rights violations (Flaherty et al., 1988 as cited in
Hoffman et al., 2006). In the 1970s, immigration patters shifted to favor US immigration,
as religious observation declined and immigrants saw greater economic and occupational
opportunities in the United States. During the 1980s, Russian emigration declined, but
resumed following the end of the Cold War and collapse of the Soviet Union. Since the
1990s, most Russian-speaking immigrants to the United States have been Christians
seeking economic and occupational opportunities (Hoffman et al., 2006).
Life of Slavic immigrant elderly. Immigration demands that people acculturate
and adjust to many changes: in environment, in new culture and a new language. Through
the process of acculturating and adjusting to the changes, most people, especially those
who immigrate as adults are expected to deal with a tremendous amount of stress. Many
immigrants struggle with social isolation, lowered social status, financial problems, a
language barrier, and cultural differences. Within this group, elderly immigrants have the
combined talk of two major sources of stress: aging and immigration (Casado & Leung,
2001).
5
In a study to measure the English Acculturation Stress and its relationship with
psychological and physical health status in a sample of elderly Russian immigrants,
researchers have concluded that indeed, language problem is a risk factor of alienation
and distress among immigrants (Tran, Sung, & Huyng-Hohnbaum, 2008). Research has
shown that lacking English communication skills has been found to relate to distress
during the acculturation process (Aroian & Norris, 2002; Tran, 1990; Mutchler &
Brailler, 1999, as cited in Tran, Sung, & Huyung-Hohnbaum, 2008). Previous studies
have confirmed the negative correlation between English proficiency and depression
among the elderly Russian immigrant population. Some stressors faced by elderly
Russian immigrants range from basic issues of not being able to communicate with
strangers to more serious concerns, such as access to necessary health care (Kropf,
Nackerud, & Gorokhovski, 1999 as cited in Tran, Sung, & Huyung-Hohnbaum, 2008). A
study on older women from the former Soviet Union also found that English proficiency
was significantly related to lower acculturative stress and stronger resilience (Miller &
Chandler, 2002 as cited in Tran, Sung, & Huyung-Hohnbaum, 2008).
Acculturation to American society is marked by linguistic, economic and social
factors. Linguistic acculturation posits that new immigrants will become more and more
accustomed to hearing and using the language of their new residence. For immigrants to
the United States, learning English would be functional in getting access to needed
services and for day-to-day living needs. While the majority of new immigrants have
relatives, friends or others to help them translate, it is assumed that immigrants have
become fully adjusted to the new country when they can communicate in the new
6
language. Learning the new language has enormous implications for personal growth as it
allows immigrants and refugees to receive and process information that has impact on
their quality of life.
Slavic cultural background. In Slavic culture, the family is the center for a
person, and family harmony is emphasized. Therefore, if a person is in emotional and
substantial need, he seeks help within his family. If a family is in trouble for any reason,
the family issues usually are first dealt within the family boundaries. For Slavic
immigrant older adults, the concept of filial piety and its value are very significant in
their lives, and the relationship between parents and children is always considered as a
major factor of a successful life and life satisfaction. The emigration policy of the former
Soviet Union considered the unit of emigration to be the family rather than the individual,
and Brod and Hurtin-Roberts (1992 as cited in Leipzig, 2006) point out that the older
Russian-speaking immigrants left for the sake of the children rather than a personal
commitment or desire to emigrate. In the Slavic culture, the importance of blood ties and
purity of bloodline is emphasized. Thus, even though mixed ethnicity marriages are
growing among Slavic Americans, some Russian-speaking elders may consider the
mixed ethnicity marriages as a distinct break from tradition and be reluctant to accept it.
In regards to health beliefs, it is not surprising to meet Slavic elders who prefer home
remedies and acupuncture, and show a negative attitude toward mental illness, even
depression or anxiety. The general negative attitudes regarding mental health services
makes make them hesitant to seek services. Mental health and psychotherapy is a foreign
concept to many immigrants. Because of their lack of familiarity with mental health
7
concepts, many immigrants tend to harbor numerous misconceptions about
psychotherapy and counseling, in general. Leipzig (2006) points out that there is a stigma
associated with psychotherapy that Russian-speaking clients have, and that she believes
stems from the cultural belief that only “crazy” people need psychological help and the
cultural norm against sharing private matters with outsiders. Consequently, most minority
individuals are likely to approach counseling with a great deal of suspicion and
resistance. Therefore, Leipzig feels it is necessary to explain to them that a therapist also
works with normal healthy people who are simply experiencing adjustment difficulties.
Statement of the Research Problem
The limited studies on Russian-speaking immigrants have paid attention to more
general Slavic Americans than older Slavic immigrants. The areas of studies and research
have included Slavic immigrant history, demographics, economic and health status,
acculturation, and the immigrant family. Most of the studies have a tendency to be done
on the populations living in metropolitan areas like New York, Oregon, Los Angeles, and
San Francisco. At this point, what should be noticed are the immigrant elders living in
other areas of the metropolitan cities. Such immigrant communities are more likely to be
disadvantaged especially in getting involved in social activities provided in their own
culture and language. Such limited social environments, especially cultural based
environments, can cause minority elderly to feel isolated and lonely.
Sacramento, as the capital of the state of California, is an area in which Slavic
populations are rapidly growing. In 2002, Time Magazine identified Sacramento as the
most racially/ethnically integrated major city in America (Lim, 2008). Sacramento is
8
home to over 200,000 immigrants from the former Soviet Union. Despite the growth in
numbers of Slavs, however, the services and activities for Russian-speaking elders are
still relatively very limited compared to other metropolitan areas such as San Francisco
and Los Angeles.
Purpose of the Study
The primary purpose for this study is to understand the perceptions older Slavic
immigrants have on aging successfully in America and the development of their
definition on what successful aging is. The second purpose of this study is to suggest
implications for social services in Sacramento that are both cultural competent and meets
the needs of the Slavic elderly community.
Research Question
This study was designed to investigate the following question: How do Slavic
immigrants and refugees define successful aging in America and what factors contribute
to its success.
Definition of Terms
Successful Aging. In the areas of gerontology and medicine, the issue of how
people age successfully has been studied since 1980s. The concept of aging successfully
is based on psychosocial theory and its key points are how to minimize the potential
debilitating effects of physical and mental decline and how to maintain physical and
mental health as long as possible. Baltes, Rowe and Kahn are first of many leading
lifespan developmentalists and gerontologists to promote successful aging. Components
of successful aging, according to Rowe and Kahn, are defined by these conditions: low
9
risk of disease and disease-related disability, high mental and physical function, and
active management with life (Friedrich, 2001). Additional to Rowe and Kahn’s
definition, Baltes and Baltes (1990 as cited in Friedrick, 2001) also suggested multiple
criteria in defining successful aging. They identified the following criteria: length of life,
biological health, mental health, cognitive efficacy, social competence and productivity,
personal control, and life satisfaction. These criteria, with additional ones of financial and
spiritual health, are used to assess normal and pathological aging, as well as successful
aging.
Assumptions
The Slavic immigrant elderly in Sacramento County may have their own sociodemographic characteristics according to not only their own immigrant background and
family history in micro and macro levels, but also their environments in the macro level.
Their socio-demographic characteristics and the external environment may influence
their daily routine and activities, their attitude toward their present life situation and life
stage, their mental health, their degree of personal self-regard, their perceived physical
health, their financial situation and their social relationships and contacts. It is assumed in
this study that the natural course of aging is a viable healthy process of life and does not
itself debilitate an individual. It is also assumed that Slavic immigrant elderly may want
to have a better physical and mental health condition, but have strong supports from both
personal and social relationships and believe it is easier to grow old in America than in
their home countries.
10
Justification
Human well-being is the primary mission of the social work profession. Viewing
the historical feature of social work, not only individual well-being in a social context but
also the well-being of society has been the focus of the social work profession (NASW,
1999). The issues such as social justice and social change are emphasized as one of the
ultimate goals of the social work profession. Interest in cultural and ethnic diversity and
the importance of this awareness have also been addressed in today’s social work
profession (1999). With this demand to be aware of cultural and ethnic diversity, social
workers are prompted to understand culture and its function in human behavior and
society and have knowledge base of the client’s culture, its uniqueness and differences.
This study would be applicable to the profession of social work in terms of the cultural
competence and social diversity. The results of this project will assist social service
providers in recognizing and responding to the needs of Slavic elderly immigrants. It will
help in the development of policies and programs to establish and support immigrantfriendly communities that will then make services available and accessible so they may
continue to age successfully. This study will benefit the social work profession by
providing understanding and insight of the needs and abilities of this growing portion of
our population, the Slavic elderly cohort.
Delimitation
This project is meant to explore the perceptions older Slavic immigrants have on
aging successfully in America and the development of their definition on what successful
aging is. This research is focused on examining the level of aging successfully among
11
only Slavic immigrants in a single group who live in the area of Sacramento whose
Slavic immigrant elders have never been studied before. The data is limited to what the
participants chose to report and the participants’ interpretation of the individual
questions.
12
Chapter 2
REVIEW OF THE LITERATURE
A review of the literature on successful aging from the view of the elderly reveals
a lack of available literature on the subject from the view of Slavic elderly immigrants
themselves. Though the concepts of successful aging is not new, only after the dramatic
increase in the interest of boomer cohort in the 1990s and the beginning of this new
millennium has the field of Social Work begun to explore the group’s importance and
impact on the community at large. Recently, the literature began to give attention to the
long-lived population. This research looks further at the growing population with an
emphasis on the Slavic elderly immigrants and refugees.
In reviewing the literature regarding successful aging from the view of the
elderly, several principal themes or subject areas were identified as related to the elderly
people’s reasons for successful aging. This literature review is organized into sections
that address the different areas identified.
Given the innovation of this subject, it seems fitting that the chosen themes are of
an introductory nature. Keeping in step with the forerunners of this area of study, Rowe
and Kahn (1998), Baltes and Baltes (1990), and other contributors, this review highlights
the principal themes mentioned in addition to presenting any new aspect of knowledge
about the Slavic elderly community in Sacramento.
13
Demographic Facts about Aging in America
Around the world, the population is aging. In 2006, almost 500 million people
worldwide were 65 and greater, and this is expected to top one billion by 2030 (Weir,
Meisner, & Baker, 2010). This is equivalent to one in every eight of the earth’s
inhabitants (US Department of State, 2007 as cited in Weir, Meisner, & Baker, 2010).
Potential consequences of an aging population are felt in almost every sector of society:
healthcare, economics, education, and at the workplace. For the average person, aging is
an inevitable part of life; however, as it pertains to later life, it has been documented that
not every older adult ages at the same rate, or to the same extent (Freedman, Martin,
& Schoeni, 2002 as cited in Weir, Meisner, & Baker, 2010; Duay & Brian 2007). In
actuality, some older adults do not follow the typical aging profile at all.
The oldest-old, defined as those 85 years of age and older, is the fastest growing
segment of the senior citizen population. Since, 1965, the oldest-old group, representing
once percent of the total population, has doubled, and has grown 40% since 1980
(Friedrich, 2001). The number of centenarians (those 100 years of age or older) doubled
during the 1980s as well. Three major demographic trends are primarily responsible
for the growing number of older adults and changing characteristics of the older
population. These include a decline in fertility, an increase in longevity, and the aging of
the baby-boom generation.
Numerous types of aging exist. It is timely to address those here. Two types of
aging are presented; the first deals with definitions of aging, while the latter focuses on
conditions of aging.
14
Definitions of Age
Chronological age. Chronological age refers to time, in number of years, for a
person since birth. Researchers sometimes make this definition even more general by the
use of terms like levels, periods, phases, or stages. Chronological age is a rather simple
unit of measure of development that does not directly cause any condition or behavior.
Physical or biological age. Biological aging is the natural aging process and
inevitable changes to all aging people. Biological aging refers to the physical changes
occurring in vital organ structures and function capacities such as those associated with
the cardiovascular, nervous, and pulmonary systems (Friedrich, 2001). According to
Friedrich, the younger one’s physical age, the better the biological quality of life, as well
as length of life. The researchers also claim that one’s physical or biological age is not
necessarily highly correlated with his or her chronological age. It is common to witness
individuals of the same chronological age, especially in older adulthood, who differ
greatly in terms of physical age. Many physical changes evolve with age that is not
disease, but normal losses of function. Even though physical change associated with
aging is a common and natural aging process, the degree and speed of physical changes
and the impacts of those changes differ by individuals.
Psychological age. Age brings not only physical changes but also psychological
changes which occur in cognitive and emotional functioning among elders. Through
psychological changes, people experience some changes in their personality and
cognitive functioning (Richardson & Barusch, 2006), and such changes were well
explained by Carl Jung. Carl Jung stated psychological development with two stages: the
15
pre-forty stage and the post-forty stage (2006). In the pre-forty stage, people face a lot of
demands from outside forces. They have responsibilities for family and career, and
struggle to expand and maintain their social networks. Jung described the post-forty stage
as associated with a reassessment of the previous stage as people tend to reflect on their
lives to find meaning and purpose as they confront biological changes. According to
Jung, in this stage, people may recognize different points of view toward their lives or
outer world that they have not experienced or noticed in the past, and become more
individuated, more integrated, and more aware of their own personalities. Often this bring
people at this stage some changes in personalities and behaviors.
Conditions of Aging
Normal Aging. According to Baltes and Baltes (1990) as cited in Smayer and
Qualls (1999), normal aging refers to aging without biological or mental pathology.
Baltes and Baltes’s definition further suggests that normal aging does not include
manifest illness. In Atchley’s definition, the term normal aging refers to usual, commonly
encountered patters of human aging (1999). Atchley believes that because there is a
sociocultural overlay that interacts with physical and mental aging, normal aging can be
expected to differ from culture to culture. McLaughlin et al., (2010) assert that a valid
concept of normal aging must portray a general picture of aging that represents accurately
the experience of aging for a large majority of people within a specific culture. For
example, normal aging in in the United States in the late 1980s implies no disabling
chronic or acute disease. Normally aging people are independent adults with persistent
self-concepts and identities. They can successfully meet their needs for income, housing,
16
health care, nutrition, clothing, transportation, and recreation. They lead active,
satisfying, and purposeful lives that involve adequate networks of long-standing social
relationships (2010).
Pathological aging. Pathological aging is an expression of either acute or chronic
disease in which normal aging patterns are not followed. Usually with pathological aging,
there is more rapid deterioration of certain structures and capabilities and more rapid
deterioration of the person in general (Smayer & Qualls, 1999). Researchers conclude
that pathological aging can occur at any stage of the lifespan (1999).
Successful aging. Like normal and pathological aging, successful aging is a
concept or generalization. Successful aging refers to characteristics of aging individuals,
who live long, productive, and satisfactory lives (Bowling, 2007; Litwin, 2005; Ron,
2007). While pathological aging can certainly reduce life expectancy, such abnormal
physical aging should limit a person from having a productive, satisfying life. Some
professionals have used optimal aging or exceptional aging instead of successful aging in
articulating the realities of maximizing one’s potentials, especially during older
adulthood (Phillipson, 1998). Researchers share that few individuals fit into any of the
three aging conditions-normal, pathological, and successful (1998). As we age, it is likely
that we will exhibit all three aging conditions in one or more capabilities. Perhaps the
objective is to minimize pathological aging and maximize successful aging in those
capabilities we have most direct control over.
17
Measuring Successful Aging
Research on aging has demonstrated that many individuals can age successfully,
and that this “success” is realized in different ways by different individuals
(Bowling, 2007; Depp & Jeste, 2006; Rowe & Kahn, 1998; Strawbridge, Wallhagen, &
Cohen, 2002). In a review of the literature on successful aging, Depp and Jeste (2006)
found 28 studies with 29 different definitions of successful aging, including both
objective ratings based on criteria determined by the researchers and subjective
assessments by older adults themselves. Today, most of the major perspectives on
successful aging assume a multidimensional measurement approach. However, the
perspectives differ in the extent to which they define successful aging as an objective,
measurable state of being or portray it in more subjective terms (Duay & Bryan, 2006).
To date, successful aging has been characterized as either 1) an objective assessment of
an individual’s status on biopychosocial factors compared with peers or 2) as an older
adult’s subjective assessment of how they are aging (Ferri & Pruchno, 2009).
Objective measurement of successful aging is based primarily on Rowe and Kahn
model (1998), which emphasizes the difference between usual aging and successful
aging. Rowe and Kahn define successful aging in terms of three components: (a) low
probability of disease and disease-related disability; (b) high cognitive and physical
functional capacity; (c) and active engagement with life (1998). For Rowe and Kahn,
successful aging is more than the absence of disease or the maintenance of functional
capabilities. These two components must be combined with active engagement in
interpersonal relationships and productive work for the construct to be represented fully.
18
Based on the largest study of 1988, the MacArthur study of successful aging
recognizes individuals who are in the top 33rd percentile across all there domains are
considered aging successfully. The MacArthur study of successful aging included 1,189
adults aged 70 to 79 years in the Established Populations for Epidemiologic Studies of
the Elderly (EPESE) studies who were in the top third on various measures of physical
and mental function (Rowe & Kahn, 1998). In follow-up studies over eight years,
participants with higher mental function were more likely to retain good physical
function. Frequency of emotional support from others was also a strong predictor of
maintaining physical functioning over time. In this sample of successful agers, nearly
25% improved their functioning over time, challenging the notion of aging as a course of
physical and mental decline (Rowe & Kahn, 1998).
Although objective models of successful aging are important, researchers suggest
that the concept is more usefully defined with broader, more subjective criteria. Guse and
Masesar (1999) as cited in Duay and Bryan (2006) point out that the physical and
functional components of Rowe and Kahn’s model disqualify disabled elderly from
achieving a classification of successfully aged. Other criticisms of the model include its
narrowness given the high prevalence of chronic disease in older age, neglect of life
course dynamics and of other routes to successful aging, failure to address adaptation to,
and management of, disease, neglect of those who are incapacitated or socially
marginalized, and who cannot age successfully by the criteria used (Crowtheret al., 2002;
Holstein & Minkler, 2003 as cited in Bowling, 2007). Masoro (2001) as cited in Bowling
19
(2007) also commented that reaching a disease and disability-free advanced old age was
realistic only for the few.
To support their notion, Guse and Masesar interviewed residents of a long-term
care facility concerning their perceptions of aging successfully. Residents identified a
number of themes including being friendly, having a sense of humor, helping others,
adapting to changes, and having fun whenever possible (Duay & Bryan, 2006). Similarly,
in another study, community dwelling middle-aged and older adults defined positive
functioning in terms of accepting change, helping others, enjoying life, and having a
sense of humor (Ryff, 1989). In yet another study, Fisher (1995) interviewed elderly
participants in a foster grandparent program and identified several features of successful
aging such as interactions with others, a sense of purpose, self-acceptance, and autonomy.
A third major perspective on successful aging is Baltes and Baltes (1990) model
of selective optimization with compensation. According to this model, people become
more selective in choosing activities and interests as they grow older. Although they
become more selective, they seek to maximize their chances of achieving desirable
outcomes or goals within their selected domains (optimization). Whenever a strategy or
means for achieving success is no longer available (e.g.,hearing loss), individuals
compensate by using other physical, psychological, or technological strategies (e.g.,
learning new skills, acquiring a hearing aid, etc.). Thus, although a person may suffer
from a reduction in physical or functional capacity, they may be able to adapt effectively
to their situation through the process of selection, optimization, and compensation (Duay
& Bryan, 2006; Friedrich, 2001).
20
Several very recent studies suggest that aspects from all three of the main
perspectives are useful in defining successful aging. For example, Tate, Lah, and Cuddy
(2003) surveyed 1,821 males over the age of 65 on their definition of successful aging.
Health was the most frequent response theme with 30% of participants describing
health-related issues. Other important themes included a satisfying lifestyle (28.4%),
keeping active in general (20.5%), keeping active physically (19.6%), maintaining a
positive attitude (18.8%), having close relationships (18.5%), maintaining independence
(16.7%), keeping active mentally (12%), and accepting growing old (10.4%). Two
smaller studies produced similar results. Duay and Bryan (2006) asked 18 older adults to
describe successful aging. The respondents mentioned engaging with others; coping with
change; and maintaining physical, mental, and financial health. In another small study,
Fisher (1992) asked19 senior center participants in the age group of 62 to 85 years to
explain what successful aging meant to them. The older adults described successful aging
in terms of health, happiness, learning new things, staying active, close personal
relationships, having a positive outlook, and overall quality of life.
In an exploratory study to understand how older adults define successful aging
and to examine relationships between physical health, functional ability, well-being, and
subjective assessment of successful aging, Ferri and Pruchnno (2009) surveyed fiftythree community dwelling adults, ages 60 and older. For the open-ended question, “How
would you define the term Successful Aging?” 74% of participants wrote responses. The
most frequently generated response was in the activity/exercise category, with 56% of
responses including this in the definition. Forty-six percent of responses mentioned
21
physical health in the definition, 41% mentioned social relationships, and 33% mentioned
psychological/cognitive health. Twenty-three percent of responses mentioned
independence, 15% mentioned good daily habits like diet and sleep, and 13% financial
security (2009).
Litwin (2005) who looked at a diverse sample of 3,403 Israelis found that
successful aging was generally indicated by life satisfaction. However, while health
status was a significant predictor of successful aging among Jewish, Arab, and immigrant
participants, there was considerable variation in other predictors. Thus, the correlates of
successful aging were in part universal and in part population specific.
Gender and Successful Aging. In a study on the elderly, it is very important to
look at gender differences among the older populations. As addressed before, the number
of people over age 65 is expected to double to 71.5 million by the year 2010 (USDCESA,
2004 as cited in Rossen, 2006), and women over age 65 are the fastest growing segment
of the population. In fact, in 2003 older women outnumbered older men by 140 to 100
(Administration on Aging, 2005). Older adults experience many life transitions or
changes in life situations, such as loss of spouse, or relocation to a new place of living,
that result in new life patterns and perhaps even changes in well-being. According to a
report on Older Americans 2000, older women are less likely than older men to be
currently married and are more likely to live alone. In 1998, about 41 percent of older
women were living alone, compared with 17 percent of older men. In addition, the
financial status among female elders was lower than older men.
22
Despite these statistics, in 50% of the longitudinal studies reviewed in metaanalysis by Depp and Jeste (2006), women experienced higher levels of successful aging
than men, whereas only one longitudinal study found that men had higher levels of
successful aging ( Ford et al., 2000 as cited in Pruchno, et al., 2010 ). Rossen, Knafl, and
Flood’s (2006) study is one of the few aimed at studying older women’s perception on
aging. Thirty-one urban, English- speaking, women between the ages of 61 and 90,
participated in the study. The majority of the women in the study were widowed, and had
a very low income. The women on average rated their health as good, and reported that
they were somewhat satisfied with their health. As with many older Americans, most of
the women reported more than one medical condition, the most common being arthritis,
hypertension, and cardiovascular disease. Most of the women described themselves as
aging successfully, revealing three major themes as components to their success:
acceptance, engagement, and comportment (2006).
Spirituality and Successful Aging. Definitions of successful aging have
predominantly focused on a state of optimal being, in relation to high levels of physical,
psychological and social health and functioning (Rowe & Kahn, 1998 as cited in Sadler
& Biggs, 2006), largely ignoring spirituality as a key dimension. Spirituality refers to the
most animating or vital issues of life, providing a sense of purpose and meaning in life.
Spiritual experiences offer an awareness of inner peace, harmony, hopefulness, and
compassion for others (Lawler-Row & Elliott, 2009).
23
According to Crowther et al., (2002) religion and medicine have been closely
linked, but not until the end of the 20th century, that science has seriously began to study
the relation between measures of religion, spirituality, health and aging. Due to the
growing recognition that religious and spiritual beliefs are being practiced more among
the American population, professional organizations are increasingly calling for better
integration of religious and spiritual issues in assessment and treatment (2002).
Religious or spiritual involvements in old age bring older people not only positive
effects on functional ability, health, and life satisfaction, but also positive influences on
life style, marriage, and social support (Ardelt, 2003). Several researchers have found
that religious activity, particularly when it occurs in the setting of community such as
involvement in religious worship services, and related voluntary activity is associated
with longer life span (Glass, Mendes de Leon, Marottoli, & Berkman, 1999; Hummer,
Rogers, Nam & Ellison, 1999; Oman & Reed, 1998 as cited in Crowther et al., 2002).
Additionally, several studies have shown a positive association between religious
involvement and better adaptation to medical illness (Sadler & Biggs, 2006). Religious
activity has also been associated with better compliance with antihypertensive therapy
(Koenig, George, Cohen, et al., 1998 as cited in Crowther et al., 2002).
Koenig et al., (2002) believes that religiously committed persons are less likely to
engage in health behaviors like cigarette smoking and excessive alcohol use. In this
way, religion may help to prevent the negative health consequences that follow these
unhealthy behaviors. On the other hand, these persons are often involved in close family
24
systems and supportive communities, which may have effects on health through other
explanatory mechanisms.
A positive association between religious involvement and mental health has been
found in many studies. Koenig, George, and Peterson, found that level of religious
commitment predicts speed of recovery from depression (1998 as cited in Crowther et al.,
2002). Nearly 850 studies have now examined the relation between religious involvement
and some indicator of mental health. Many of the studies have been conducted in
medically ill patients or older persons suffering with chronic disability. The vast majority
of such studies do indeed find that religious involvement is associated with greater wellbeing and life satisfaction, greater purpose and meaning in life, greater hope and
optimism, less anxiety and depression, more stable marriages and lower rates of
substance abuse (Koenig, McCullough, & Larson, 2000 as cited in Crowther et al., 2002).
Slavic Elderly Immigrants and Refugees
Migration history. Most Russian immigrants came to the United States during
one of four waves. The first group, made up primarily of Jews from the outlying
territories of the Russian Empire, came to the U.S. in the late nineteenth century as a
result of anti-Semitism and persecution during the Czarist period. The second wave came
to the United States in the years following the twin upheavals of World War I and the
Bolshevik Revolution that overthrew the Czar and resulted in the creation of the Soviet
Union. The third wave immigrated following the devastation of World War II. Finally,
the fourth wave began after the Soviet government loosened emigration restrictions
during the mid-1980s. The collapse of the Soviet Union and the resulting social and
25
economic dislocation accelerated emigration from the former Soviet Republics
(Springfield, 2009).
There are several reasons why these large numbers of Russian-speaking
immigrants are coming to the United States. As a result of the 1989 dissolution, large
number of Jews and Christians left the Former Soviet Union due to religious
discrimination. Other emigrants left seeking improved social and economic conditions.
Soviet Jewish emigration in particular has exceeded a million people and most
immigrated to the United States and Israel. More than 460,000 were estimated to have
immigrated from the Former Soviet Union to the United States between 1991 and 2000.
In 1999 alone, combined immigration from Russia and Ukraine ranked 5th among
countries from which legal immigrants were admitted to the United States, and
throughout the 1990s they constituted the largest group accepted with refugee status
(Miller & Gross, 2004). According to Brod and Heurtin-Roberts (1992), 20% of refugees
and immigrants from the Former Soviet Union are over 65, which makes them one of the
oldest groups of immigrants in this country (as cited in Fitzpatrick & Freed, 2000). Out of
23,300 resettled immigrants arriving between 1979 and 1989, 58.9 percent were aged 61–
71 years,31.2 percent were aged 71–80, and 10 percent were 81 years and
over (HIAS, 1991 as cited in Fitzpatrick & Freed, 2000).
The primary motivation for older Jewish Russians to migrate to America is based
on the expectations of their adult children that they join them (Althausen, 1993).
However, upon relocation to the USA, the relationship between the two generations
26
changes because the elderly parents are now overly dependent upon the adult children
and roles are reversed. This often contributes to intergenerational conflicts, physical
illness and disabilities among the aged (Fitzpatrick & Freed, 2000).
Psychological and Social Issues
Family values. Russian political and economic system has a history of placing a
strong emphasis on parental authority and power (Althausen, 1993). As a result, there
remain well-defined roles within a strong family tradition of exchange between adult
children and their elderly parents, in which exchange of good and services is usually a
two-way interaction (Fitzpatrick & Freed, 2000). In return for grand-parenting assistance
and financial contributions, adult children are expected to provide extended care for their
aging parents. However, when the elderly leave their homeland, they suffer significant
losses associated with their authority in their family and their professional status, and
upon arrival in the USA they experience cultural and language barriers and reduced
authority, status and roles. These losses as well as any health-related illnesses often force
their adult children to assume a greater position of responsibility for their parents. This in
turn contributes to emotional and physical stresses for the adult children, due to their own
unresolved issues of separation and role changes.
Althausen (1993) identifies that in this country the elderly Slavic experience can
be best understood in terms of separation and individuation struggle between the elderly
and their adult children. Oddly enough, in the USA the family unit is viewed as two
separate families, and the goal of most resettlement agencies is to eventually separate the
generations into their own households (Althausen, 1993; Fitzpatrick &Freed, 2000;
27
Resick, 2008). In contrast, in the Former Soviet Union the entire family system lived
under one roof. Establishing two separate households is experienced ambivalently,
especially by the elderly, because is it usually the first time older family members are
separated from their children. This increases their sense of isolation and loneliness in a
foreign country and may cause problems in separation and individuation for both the
elderly and their adult children. Even when they do not live apart, the issue becomes one
in which the extreme dependency of the aged person upon their children occurs at a time
when their children are struggling with their own adaptation and acculturation problems
in a new country (Resick, 2008).
Intergenerational Issues and Family Caregiving
Immigration and resettlement is an experience often fraught with great conflict
and ambivalence, especially for elderly Russian immigrants. They frequently find
themselves alone during the day as their adult children work; many become a burden to
their children as their dependency from age-related physical illnesses and disabilities
increases (Tran, Khatutsky, Aroian, Balsam, & Conway, 2000). Adult children,
particularly women, frequently become less available to provide the 24-hour-aday
supervision needed to care for their disabled elderly relatives. This problem may have
occurred in their home country, but because there were other relatives and friends to help,
it was not as serious. Therefore, the extreme dependence of the sickly aged may also be
attributed to the fact that they have lost their own support system outside their home. The
elderly must now rely on their adult children, who learn English more quickly, for
assistance in negotiating the health care system and government bureaucracies, as well as
28
for help with personal problems after their arrival in the new country. Role shifts are said
to occur as a result of changes and losses associated with life transitions and in particular
in the process of adjustment in a new country (Miller, Wang, Szalacha, & Sorokin, 2009).
Often the elderly person in FSU was in a position of authority and respect,
responsible for childcare and even for financial assistance. Fitzpatrick and Freed (2000)
indicate that the transition for the elderly now involves an autonomous yet dependent
relationship in which the elder moves from an “undifferentiated life stage in the old
country to a more differentiated position in the family.” Researchers believe that this
may either create overdependence or, if they must live separately, an independence for
which they are not prepared. This separation-individuation process, which forces greater
intergenerational distancing between the elderly and their children, can be observed in the
context of language acquisition and differences in the values and needs between the
generations (Gusovsky, 1995 as cited in Fitzpatrick & Freed, 2000). Younger generations
have greater opportunities to learn English and integrate themselves into the larger
society, while their parents or grandparents remain more entrenched in the old-world
values and customs, which now seem obsolete to younger family members. As a result of
these differences and changes, the older generation may react to these losses with feelings
of depression and even hopelessness, thus causing further conflict and guilt. Their adult
children feel burdened and pressured into providing continued emotional support and
safeguarding their elder’s medical care (Althausen, 1993; Greenberg and Kennedy, 1997
as cited in Fitzpatrick & Freed 2000). Additionally, conflict develops when medical
problems arise and family members may eventually be forced to make a decision
29
regarding the institutionalization of their elderly relative. The family’s first choice would
be to provide care in their homes similar to their practices in the old country. However,
due to new responsibilities and pressures outside the home, adult children are not able to
provide the care as readily as before. Nursing home placement, therefore, becomes the
perfect example of separation and abandonment for the elderly immigrant and the
younger generations are left with extreme feelings of guilt and regret.
Physical and Mental Health Status
New immigrants face significant post immigration challenges. Learning a new
language and mastering seemingly routine daily activities produce acculturative stress.
Depression is a commonly identified problem for Asian, Middle Eastern, and Latina
women following immigration to the United States and has been documented repeatedly
for Ethiopian and Russian immigrants in Israel and the United States. Studies of
immigrants from the FSU in which gender differences are assessed tend to find more
psychological distress in women than in men (Miller & Gross, 2004).
Age has been shown consistently to be a correlate of psychological symptoms in
immigrants, and people who immigrate during or after their midlife years tend to have
greater distress (Miller & Gross, 2004). Midlife and older immigrants may be at highest
risk, since younger immigrants tend to acculturate more easily, are able to find jobs, and
are less depressed. Many midlife immigrants have great difficulty finding jobs equivalent
to those they held in the FSU, experience unemployment or underemployment, and
consequently suffer losses in both their occupational status and their personal identity.
30
In addition, other demographic characteristics appear to increase vulnerability to
depression in immigrants. Findings for the relationship between marital status and
depression in immigrants are unclear, and suggest that there are complex interactions
among gender roles, social support, and psychological distress. In Miller and Gross’
study on health and depression in women from former Soviet Union, marital status did
not predict depression. Other studies found that non-married immigrants had higher
demoralization and suicidal ideation. Flaherty et al. (2000) as cited in Miller and Gross
(2004) found that although married women from the FSU were more demoralized than
single women, single men were less demoralized than married men. Interactions between
gender and marital status were also demonstrated by Baider et al. (2001) as cited in
Miller and Gross (2004), who found that unmarried women had the highest scores for
depression compared to married women and men.
In addition to demographic characteristics, physical health status is a very strong
predictor of depression in older immigrants (Duncan & Simmons, 1996). Immigrants
from the FSU bring with them high levels of psychological distress and somatic
complaints due to health care inadequacies, social disruption, and political instability
in their native country, and these pre migration factors continue to affect their physical
and mental health. They have high levels of cardiovascular risk and hypertension, as well
as other chronic illnesses that are related to depression. Their health status and attitudes
toward seeking care influence utilization of health services (Miller & Gross, 2004).
31
Theoretical Framework
Acculturation. Miller, Wang, Szalacha, and Sorokin (2009) explain that
examining the acculturation processes inherent to the experience of immigration is
necessary before we can understand their effects on health, mental health, and adaptation.
The researchers claim that acculturation broadly refers to selective adoption and retention
of language, identity, behavior, and values as they are maintained or transformed by the
experience of coming into contact with another culture. It is a dynamic cognitive and
emotional process of accessing, understanding, and/or adopting specific aspects or
characteristics of a new culture. On an individual level, it is a complex process of conflict
and negotiation between two cultures and includes changes that occur as one
accommodates to a new cultural milieu.
Fitzpatrick and Freed (2000) note that the goals of acculturation have become a
priority for resettlement agencies due to the difficulties encountered with the first wave of
Russian Jewish immigrants. Nasitir (1991) and Belozersky (1990) as cited in Fitzpatrick
and Freed (2000) state that acculturation is a complex process and can be an individual
experience, taking place over a long period of time. Despite the fact that Russian
immigrants receive one of the most well-funded and professionally staffed resettlement
programs for recent immigrants, difficulties in adjusting to the loss of family and friends
and major problems in learning English persist. This suggests that the elderly are equally
or even more affected by these problems than the younger generations of family
members.
32
Activity Theory. Activity theory was the first theory in North America to attempt
to provide a description of, and a prescription for successful aging in the later years of
life. This theory argued that individual adaptation involved continuing an active lifestyle
of social interaction in order to maintain the self-concept and hence a sense of well-being
of life satisfaction (McPherson, 1983). Despite some criticism, it is without doubt that
participation in activities in older age is crucial to restore and maintain one’s self and
create a sense of happiness within the individual.
For a number of years this theory was the basis for much of the social
programming and serviced provided to the elderly. There is considerable evidence that
being physically and mentally active helps to maintain the physiological, psychological,
and intellectual functioning of older people.
Summary
Fewer Americans now die prematurely. The average life span in the United States
has increased 26 years in this century, from 47 to 73 years. Age is probably best defined
as the developmental sequence of all the biological, social, and psychological processes
as they change with the passage of time.
Lately, in the field of Gerontology and Social Work there has been a surge of
interest in understanding and promoting successful aging. The literature on aging reveals
that there are numerous factors that contribute to the success in one’s life. In one of the
first studies on successful aging, participants with higher mental function and frequency
of emotional support were more likely to retain good physical function and age
successfully. Latter similar studies found that health, happiness, physical activity, social
33
connectedness, and life satisfaction are directly correlated to successful aging. Finally,
several studies have shown positive association between spirituality and religious
involvement in older age with life satisfaction.
Since the end of the 1970s, immigrants from the Former Soviet Union have
arrived in the Unites States in significant numbers. Immigration is a stressful life event,
and many elderly immigrants face problems related to inadequate housing, economic
concerns, and obtaining medical services. Service providers need to tailor their delivery
of services to the particular preferences and values of the Slavic elders in order to help
them live more productively and to contribute to the world around them.
34
Chapter 3
METHODOLOGY
Research Design
Lately, there has been a heightened interest in the promotion of aging
successfully. Much of the literature on successful aging focuses on policy initiatives to
promote autonomy and independent living in older age. While not underestimating the
importance of these to the people, such research fails to address the question of “what is
successful aging?” While there is not a clear definition of successful aging, this
researcher chose to do an ethnographic perspective study in order to better understand the
perceptions older Slavic immigrants have on aging successfully in America and the
development of their definition on what successful aging is. Ethnography, based on
Rubin and Babbie’s definition focuses on providing detailed, accurate descriptions of the
way people in a particular culture live and the way they interpret the meanings of things
(2007). This method is the best fit for this study to capture the migration experience,
belief system, and behavioral norms of this subculture. Also, using this approach will
help the researcher see the world through the eyes of the people studied. Knowledge of
older adult’s beliefs would improve the ability of providers to offer patient focused care
that is both cultural competent and meets the needs of the Slavic elderly community.
Variables
Independent variables. Socio-demographic characteristics, which are independent
variables include gender, age, marital status, living arrangement, educational status,
religious affiliation, the length of residence in the U.S., and English proficiency. Gender
35
is measured by its 2 attributes: male and female, and to measure age each participant is
asked to choose from the given items. The question of marital status has 4 attributes:
married, separated/divorced, widowed, and single. Living arrangement examines the type
of housing as well as the nature of the current living arrangement (alone or with others).
In order to obtain data on the level of each participant’s education, educational
status is measured by its 4 attributes: never attended school, finished H.S., attended
college in either U.S.A. or former Soviet Union. Religious affiliation is asked of each
participant with 5 attributes: Pentecostal, Baptist, Protestant, no religion, and other. The
length of residence in the U.S. is operationalized in years after the arrival in the U.S. and
measured by asking each participant to choose from its 3 attributes. .
English proficiency is measured by self-assessed rate to examine whether or not
participants could communicate minimally with English speakers. Those who are unable
to communicate rate themselves poor, and people who indicate themselves as fair have
some ability to communicate. Good means that a person can manage bills or documents
and communicate somewhat. Excellent means that there is no limitation to
communication in any situation.
Variables related to successful aging. The next 3 parts of the short survey
assesses participant’s views on social connectedness, health/mental health, economic
well-being, and life satisfaction/achievement. These key variables were identified
through the literature review and informants from the community.
36
Participants
Participants for the research study are first generation immigrants and refugees
from the former Soviet Union countries, ages 60 and above. The sample used for the
study consists of 17 Slavic immigrant elderly who belong to the same ethnic culture and
organization. This study employs a non-probability sampling method. Convenience
sampling and snowball strategies are used to recruit the 17 participants.
The researcher contacted participants through ethnic religious and social
organizations. The researcher approached potential participants after the “Light to the
World” church service and asked whether they would be willing to participate in a quick
survey and short interview. Because it is a small ethnic community, personal contact is
the most effective approach. Once the respondents indicated interest in participating, the
researcher set up a time and visited them at the location of their choice. Seventeen
samples were finally collected from people who agreed to participate in the survey and
they consisted of 13 females and 4 males.
Instrumentation
The researcher developed the “Successful Aging” (See Appendix B)
questionnaire of Slavic elderly immigrants based on current literature and input from
elders in Slavic community. The development of the questions is guided by the research
gathered and the understanding of the data sources. A table of specification form was
used to organize the development of the questions. Key domains for the questions include
general demographic questions such as gender, age, marital status, people with whom
participants live, type of housing, education level, and religious affiliation. In addition to
37
the general demographic questions, the researcher added socio-demographic questions
associated with personal capabilities and social relationships. The participants were also
asked to answer a question about the length of residence in the U.S. To collect data of
personal capabilities, the question on the degree of English proficiency was asked. The
question on social relationships was developed by asking how often the participants see
their family members except people living with them. The short questionnaire is
augmented by 6 open-ended interview questions to elicit unanticipated responses.
To study successful aging in America for elderly Slavic immigrants and refugees,
the remainder of the short questionnaire was broken into four categories: social
connectedness, health/mental health, economic well-being, and life satisfaction. The 4
categories of the survey are as follows: 1. Social connectedness- perceived satisfaction
with the social relationships and contacts. 2. Health- perceived physical and mental
health. 3. Economic well-being- satisfaction with the financial situation in the present. 4.
Life satisfaction- positive attitude toward one’s present life situation and a sense of
accomplishment. Each question requires respondents to select one out of the given
possible responses that best matches the way they feel. In addition to the survey, the
researcher developed an interview guide that asked the participants to define in their
words successful aging in America.
Data Gathering Procedures
After the potential respondents agreed to take part in this study, the researcher set
up a time to meet. Data was collected from elders in 8 individual interviews in their home
and in one group with 9 participants at church. Prior to the face-to-face interview, the
38
purpose of this research, the procedure of interviewing and confidentiality were
explained, and informed consent was obtained prior to their participation. Due to
education and cultural considerations, a face-to-face informal interview was utilized, and
the average length of the individual interviews was about 30 minutes, and about 2 hours
for the focus group. Communication with the respondents was done mostly in Russian.
No inducements were offered.
Protection of Human Subjects
The Human Subjects Application was submitted for approval to the California
State University, Sacramento, Division of Social Work Committee for the Protection of
Human Subjects. The survey was approved by the University as “minimal risk” because
participants may feel uncomfortable emotionally or distressed while responding to the
survey about their health, mental health, life achievement/ satisfaction, as well as
successes in life. To minimize the probability of causing participants emotional
discomfort, all participants were informed that all data collected was confidential. All 17
subjects were voluntary. In addition, each subject was informed that if he/she decides to
participate, then he/she is free to discontinue participation at any time for any reason. At
the same time, the name, phone number of Slavic Community Center was given to all
participants.
Personal questions such as the subjects’ names and identifying information were
not asked of the participants. All responses were used for analysis only and discarded
afterwards. Even though the data was collected in a face-to-face encounter, there were no
physical procedures involved, and no equipment or pharmaceuticals used for this study.
39
Data Analysis
Descriptive statistics were used to summarize demographic data. Content analysis
was then performed on the answers elicited by the interview questions. First, data was
coded according to common topical areas. Then more descriptive subcodes were assigned
to data grouped under these broad categories. Content analysis is used to determine
common themes, trends, focus, and any unique answers.
40
Chapter 4
DATA ANALYSIS AND STUDY FINDINGS
This project was meant to understand the perceptions older Slavic immigrants in
Sacramento County have on aging successfully in America and the development of their
definition of what successful aging is. The demographics of the respondents were
examined and the participant’s responses and characteristics of successful aging were
reviewed.
Descriptive Findings of Socio-demographic Variables
The researchers interviewed seventeen first generation immigrants from the
former Soviet Union countries. All of the subjects were from the Sacramento County. Of
the 17 immigrants interviewed, 76.5% (n=13) were females, and 23.5% (n=4) were
males. In the population surveyed, four of the subjects were between the ages of 70-79
years old, and thirteen were between the ages of 60-69. Seventy six point five percent of
the respondents were currently married, and 23.5 % (n=4) widowed. All of the widowed
respondents were females, and there was no one who never got married among the study
sample.
Out of the subjects surveyed, 2 (11.8%) have lived in the United States between
5-10 years. The rest of the participants, 88.2 % (n=12) have lived in the United States 10
or more years. All subjects were asked to rate their English proficiency level from: poor,
fair, good, and excellent. The data analysis indicated that 15 respondents rated their
English skill level as poor. Three respondents rated their proficiently level as fair. No one
indicated their English to be good or excellent.
41
The results of the data analysis of living arrangements indicated that 11.8% (n=2)
live alone, 76.5% (n=13) live with his/her spouse, and 11.8% (n=2) live with their
immediate family. The percentage of the participants living in a single
house/duplex/apartment is 58.8% (n=10), and 41.2% (n=7) live in a senior apartment
complex.
The religious affiliations were represented by Pentecostal, Baptist, and Protestant.
One hundred percent of the participants identified their religious affiliation as
Pentecostal. Seventy six point five percent of the respondents graduated from high school
and among them 11.8% (n=2) had some college education in their home country. Two of
the respondents (11.8%) attended college in the United States.
Fifty six point three percent of respondents answered that they see other family
members except people living with them several times a week. Another 43.8% (n= 7)
responded they see other family members about once a week.
Specific Findings
Social connectedness and successful aging. Based on the research gathered social
connectedness is a huge component of successful aging. This researcher wanted to
explore the perceived satisfaction of the elderly Slavic immigrants with social
relationships and contacts. Ten (58.8%) of the respondents answered having a few
friends, while four (23.5 %) reported having some friends, and three (17.6%) indicated
having many friends. Thirteen (76.5%) agreed to seeing their friends every day or two,
and four (23.5%) disagreed to the question. All of the participants surveyed reported
enjoying the time spend with their friends. Seventy point six percent of participants know
42
at least two of their neighbors by name, and 29.4 % (n=5) said that they did not. Among
those that reported knowing at least two of their neighbors by name, most reside in
apartment or senior apartment complex with other immigrants from former Soviet Union.
Those that reported not knowing at least two of their neighbors by name, live in single
homes. The participants that know at least two of their neighbors by name, reported
feeling comfortable in asking them for help, if assistance is needed with daily chores.
Those that do not know their neighbors by name, reported not feeling comfortable in
asking for help.
Health and successful aging. Many previous studies have found that successful
aging involves the maintenance of physical and mental health. Of the seventeen
participants, 1 participant indicated her health to be unhealthy, 7 believed to be somewhat
unhealthy, 6 indicated to be in average health, and 3 participants perceived themselves as
healthy. One participant often uses medication to maintain her health, 3 sometimes use
medications, 9 respondents always use medication, 2 seldom use medication, and 2
indicated never using medication to maintain their health. Twelve (70.6%) respondents
sometimes feel physical pain compared to 5.9% (n=1) always feeling pain, and 23.5%
(n=4) seldom feeling physical pain. Eight (47.1 %) regularly visit their doctor, whereas 6
(35.3%) sometimes visit, and 3 (17.6%) rarely visit their doctor. All seventeen
participants reported having health insurance.
On perceived mental health, all of the participants interviewed agreed to still
being mentally sharp, and all do not forget about recent events. All seventeen respondents
view themselves as happy people, and all like helping people. Eighty eight point two
43
percent responded talking to their friends about life challenges (n=15), and 11.8% (n=2)
said that they do not. The result of a cross-tabulation shows that those that disagreed to
the question of talking to their friends about life challenges are males.
Life satisfaction and successful aging. The questions on life satisfaction measure
an individual’s perception level of well-being and happiness and how satisfied people are
with their own lives. The result of data analysis indicated that 100% of the respondents
felt satisfied with life. Ninety four point one percent agreed to have done everything in
life, whereas only 5.9% (n= 1) disagreed to the question. The 94.1% (n=16) of the
participants also believed that they have achieved a lot in life, and that 5.9% (n=1)
disagreed.
Economic well-being and successful aging. The results of the data analysis of
present financial situation indicated that 17.6% (n=3) often worry about their finances,
47.1% (n=8) sometimes worry, 23.5% (n=4) seldom worry, and 11.8 % (n=2) never
worry about their finances. Two (11.8%) of participants believed their current situation is
bad, 12 (70.6%) indicated it to be fair, and 3 (17.6%) thought their doing well financially.
Four (23.5%) of the participants indicated their current income to be inadequate, 7
(41.2%) said their income is fairly adequate, 4 (23.5%) reported adequate, and only 2
(11.8%) indicated it to be very adequate. The results of a cross-tabulation test shows that
11.8% of participants that indicated that their current income is very adequate rated their
English skills as fair and have some college education in the United States.
44
Themes of Successful Aging
Participants interviewed described a variety of characteristics and behaviors
associated with successful aging. Content analysis revealed four major themes: family
functioning, sense of security and stability, coping with changes, and religious freedom.
Each of these major themes compromised several subthemes.
Family Functioning
The first significant finding of this study was that successful aging involves
maintaining close family relationships. Participants described the importance of being
with their family in the United States, engaging with them, socializing with friends, and
helping others at church. In response to the question “What are some of the things that
you believe contribute to a successful aging experience,” most of the participants
indicated that having a close relationship with their children is a component of their
success. Sveta and Ivan, both grandparents, stated: “We are proud to say that we have
raised good disciplined children. Our desire to marry our children and have grandchildren
has become true. All of our kids live close by and we see them at least couple times a
week.”
Family relationships are vital because they enable older adults to feel loved, cared
for, and appreciated. All of the participants interviewed enjoy spending time with their
grand-children. In addition to family relationships, participants emphasized the value of
getting involved in social relationships and keeping in contact with old friends and family
members in their home country. Lately, technology has enabled senior adults to connect
with family and re-establish old relationships. Olga, an immigrant from Ukraine regularly
45
talks to her children that stayed behind through Skype. She loves the fact that she can see
her children and grandchildren every day even if they are on two different continents.
For many of these participants, a sincere commitment to helping others is another
key aspect of aging successfully. Majority of the participants indicated that they received
a great deal of satisfaction when they give their time to friends and community members.
Dmitriy, Ilya, and Ivan volunteer at the local church and even though they are not as
productive as some of the younger men there, they are satisfied with being able to give
back. Many of the women interviewed also give their time by running errands for their
church sister and brothers that are bedbound. By helping others, older adults gain a sense
of purpose.
Security and Stability
The second major theme revealed in this study was the importance of security and
stability. Although these specific terms were not used, many responses revolved around
this theme, often discussed in the context of one’s living environment and social support.
Sense of stability and security was illustrated by the responses to the question “Is it easier
to grow old in America than in the former Soviet Union.” The participants replied in
complete agreement that it is easier to grow old in the United States. Many of the
participants lived in rural areas in their former countries, often relying on crops to
provide them with food. The success of their crops was hampered by heavy rain and
drought. In the United States the participants are secured knowing that they would be
taken care of if their health declined or if other life events occurred. One participant
46
stated “here in the United States you don’t have to worry about what you are going to eat
tomorrow, the government will take care of you. And that takes a lot of worry off.”
Coping with Changes
Another significant finding of this study was that successful aging means coping
with the many changes that occur in life. Immigration is a stressful life event, and these
participants discussed the importance of facing problems and dealing with them,
accepting changes that are beyond one’s control, and maintaining a positive attitude. The
women said that acceptance of changes in life circumstances, particularly physical and
environmental changes, is essential to successful aging. One participant who felt that
accepting physical changes was an important aspect of successful aging said: “I know
that I do not appear healthy. I have no feeling in my left arm but I have accepted that this
is how it is going to be. I try to keep active and do whatever I can do with my other arm.”
Acceptance of environmental change was illustrated by a woman who said: “I do
miss Ukraine and often think about my life there. But the past is in my memory and now
I have to think about living for now and make things easy for myself, my kids, and my
husband.”
Religious Freedom
In all of the interviews, freely practicing your religion emerged as a key strategy
for aging successfully. Participants described the importance of being in church and
taking part in public religious behaviors. Participating in worship services, praying with
others and having others pray for you, and visits from religious leaders at home or in the
hospital improve coping during adverse times for these participants. Participants also
47
indicated that churches not only have opportunities for religious involvement through
which their spirituality may grow, but also for social interaction which helps them feel
less isolated or lonely. For these participants, their faith and religion also play a key role
in coping with changes. A couple of participants indicated they turn to God to help them
overcome problems in their daily life. If something is bothering them, they pray, and they
feel better. For other participants, faith keeps them from becoming overwhelmed with
issues and changes: “I can’t carry the load myself. I put it on the Lord and not, try not to
take it back.”
Unique Findings
A unique finding in this study was that financial situation does not have a
significant, direct impact on successful aging. Satisfaction with standard of living and a
sense of achievement in life is of a greater importance for these participants than their
actual financial condition. This finding is best illustrated in this participant’s response: “I
wouldn’t say that my current financial situation is very adequate, but it does not mean
that I am not aging successfully. For me, is the sense that I have achieved something in
life, and I have achieved a lot.”
Summary
Successful aging appears to be multidimensional and may vary depending on the
individual and his or her interpretation of life circumstances. Successful aging appears to
have universal features, which include a sense of well-being, health/cognitive health.
However, even these concepts have broad and varied interpretations. Additionally,
culture, ethnicity, and lifestyle all play roles in defining the characteristics of successful
48
aging. In order to design appropriate intervention programs to promote successful aging
for Slavic immigrant elderly in Sacramento County, service providers need to understand
the meaning of successful aging as older adults themselves define it.
49
Chapter 5
CONCLUSIONS
Conclusions
The purpose of this study was to identify the perceptions of Slavic senior adults in
Sacramento County on aging successfully in America. The results of this study indicated
that successful aging involves: (a) family functioning; (b) security and stability; (c)
coping with changes; (d) and religious freedom. The first finding demonstrated the
importance of family, maintaining close personal relationships, and engaging with others
as one ages. This finding corresponds with the results of several large studies that found
significant positive impact for family and social support on longevity and health. Rowe
and Kahn (1998) discuss three ways in which social connectedness impacts health in
older adulthood. First, they say that isolation, or a lack of social ties, often leads to poor
health. Second, both emotional support and physical assistance have positive effects on
health. Finally, supportive social relationships can reduce some of the health related
effects on aging
Within the first theme of family functioning, participants also emphasized the
importance of helping friends and community members. The majority of these
participants indicated that by giving back it gave them a sense of purpose, meaning, and
personal satisfaction. In Fisher and Wolf’s study, many older adults looked for ways to
reestablish a sense of identity and meaning in this stage of their life (2000 as cited in
Duay & Bryan, 2006). The study concludes that volunteer work and community activism
are powerful ways to regain a sense of usefulness and purpose in older adulthood.
50
The other significant finding in this study suggested a variety of ways in which
older Slavic immigrants and refugees cope with change in their lives. These participants
described successful aging as facing problems and dealing with them, positively
accepting changes beyond one’s control, and maintaining a positive attitude. Acceptance
was a major theme in recent studies on aging successfully (Duay & Bryan, 2006; Ron,
2007; Ferri, James, & Pruchno, 2009). Duay and Bryan (2006) believe that accepting
change in situations that cannot be controlled may be a key challenge of positive aging.
Indeed, empirical research has found a relationship between acceptance and well-being in
older adulthood (Weir, Meisner, & Baker, 2000).
Certainly, religion, faith, and spirituality emerged as an important component of
aging successfully for these participants. They repeatedly described how they turned to
their faith for strength in getting through difficult times. In the past decade, research in
this area has increased significantly. Results on some major studies indicate that religious
involvement is related to greater well-being, increased life satisfaction, reduced anxiety,
and lower rates of substance abuse (Lawler-Row & Elliott, 2009). In fact, research on the
role of religion and faith in successful aging has been so promising that some researchers
are calling for a revision of Rowe and Kahn’s model to add a fourth component, positive
spirituality (Crowther, Parker, Achenbaum, Larimore, & Koenig, 2002).
Current financial situation did not seem to be an important issue for this group.
This finding contradicts several smaller studies where financial security was an important
issue for the participants interviewed. In Bowling’s (2007) study, several participants
expressed concerns about running out of money, and almost 33% of them advised young
51
people to save their money carefully. Many stated that it was important to prepare
financially so that they could continue to do what they wanted to do after retirement.
Implications
Viewing the characteristics related to successful aging, there are some important
points which should be considered when working with Slavic immigrant populations that
are less concentrated than other metropolitan areas.
The results suggest the significant role and impact of Christian churches on aging
successfully among the Slavic immigrant elderly. Churches are a very important resource
because they have opportunities not only for religious involvement through which their
spirituality may grow, but also for social interaction, which may help the elderly feel less
isolated or lonely. Social workers working with Slavic immigrant elderly are encouraged
to have an understanding of the community background related to Slavic churches and
cooperate with them in developing programs and services for Slavic immigrant elderly.
Additionally, the issues of spirituality or religiosity should be significantly considered
when dealing with successful aging in late life of the elderly.
Social workers working with Slavic immigrant elderly should consider that they
have limitations to opportunities of social networks and relationships. The lives of the
Slavic immigrant elderly in the sample are centered with their families, and those who
see their children more often are aging more successfully. Opportunities for social
services and social relationships are often limited due to cultural differences and a
language barrier. Social workers need to work collaboratively with the Slavic community
52
and suggest development of social services that are linguistically appropriate, attentive to
culturally and religious backgrounds, and addresses issues of spirituality.
For the social domain, important strategies for successful aging should attempt to
promote community connectedness. Development and maintenance of networks are
significant throughout the lifespan, especially for Slavic immigrants in the Sacramento
County. Significant networks could include family, friends, formal and informal
organizations, and one’s spiritual realm. Therefore, intervention programs need to be
family oriented, provide multi-generational activities, promote stability, and strive to
build an informal and formal sense of network. In order to design intervention programs
to promote successful aging, social providers need to understand the meaning of
successful aging as older adults themselves define it.
Limitations
Due to time constraints, the researcher selected participants using convenience
sampling and limited the study’s sample size to 17 participants. All participants in this
study resided in in the same small metropolitan area in Sacramento County, and with the
exception of two, all participants attended the same church. The study was female
dominated, thus, future research involving more male older adults is needed to determine
if the same themes apply across different genders.
Recommendations
There are two suggestions for future studies on successful aging for Slavic
immigrant elderly. First, research on successful aging with larger samples is
recommended in order to find further characteristics, and unique themes. The size of the
53
sample in this research was not big enough to make the research results generalized, and
the samples were selected within a very limited range of subjects. All participants in this
study indicated their religious denomination to be Pentecostal and all attended church on
a regular basis. Thus, it is possible that other participants not fitting this category perceive
successful aging in a different manner.
Second, a comparison study is recommended for examining the differences
between the group of older people living in metropolitan areas with large numbers of
Slavic immigrant elderly and the other group of elderly who live in other areas that have
smaller Slavic immigrant populations. This study focused on understanding the
characteristics of successful aging only among Slavic immigrant elderly who live in the
County of Sacramento, which is not a large metropolitan area.
54
APPENDICES
55
APPENDIX A
Informed Consent Form
56
INFORMED CONSENT TO PARTICIPATE IN A RESEARCH STUDY
You are invited to participate in a study to understand the perceptions elderly Slavic
immigrants have on aging successfully in America and the development of their
definition on what successful aging is. Knowledge of Slavic older adult’s beliefs would
improve the quality of cultural competent services to the Slavic elderly community. You
were selected as a possible participant in this study because you were referred to the
researcher as meeting the requirements of the study – 1) first generation immigrant from
the former Soviet Union, & 2) over the age of 60.
Should you agree to participate in this study, you will be asked to complete a survey that
will take approximately 15 minutes of your time, and a short interview. The survey has a
total of 31 questions that cover such areas as demographics, social connectedness,
health/mental health, economic well-being, and life satisfaction/achievement. After the
survey, this researcher would like to learn your opinion on the topic of successful aging.
The discomfort of participating in this study is expected to be little to none. However, if
you do experience any discomfort please feel free to contact Slavic Community Center,
2999 Fulton Ave, Sacramento, CA 95821 at (916) 485-6410.
No personal identifier is used in this study. Any information obtained in this study will
remain confidential and only group data will be reported.
Your participation is completely voluntary. If you decide to participate, you are free to
discontinue your participation at any time for any reason.
If you have any questions or comment in regard to this study, please feel free to contact
Ilona Timofey at (916) 833-2238, timofeyi@yahoo.com, or my thesis advisor Dr. Francis
Yuen at (916) 278- 7182, fyuen@csus.edu.
You will be offered a copy of this form to keep.
You are making a decision whether or not to participate. Your signature indicates that
you have read the information provided above and have decided to participate. You may
withdraw at any time without penalty or loss of benefits to which you may be entitled
after signing this form should you choose to discontinue participation in this study.
___________________________________
Signature
________________
Date
57
СОГЛАШЕНИЕ НА УЧАСТИЕ В ОПРОСЕ
Вы приглашены участвовать в опросе, чтобы понять восприятие, которое пожилые
Cлавянские иммигранты имеют при старении успешно в Америке и развитии их
определения на том, каково успешное старение. Знание восприятия Славянского
старшего поколения улучшит качество культурных компетентных услуг к
Славянскому пожилому сообществу. Вас выбрали как возможный участник этого
опроса, потому что Вы – 1) первый иммигрант поколения из прежнего Советского
Союза, & 2) после 60.
Если Вы соглашаетесь участвовать в этом опросе, Вас попросят заполнить обзор,
который займет приблизительно 15 минут Вашего времени, и короткое интервью. У
обзора есть в общей сложности 32 вопросов, которые покрывают такие области как
демография, социальная связность, здоровье/умственное здоровье, экономическое
благосостояние, и удовлетворение/достижение жизни. После обзора этот
исследователь хотел бы изучить Ваше мнение относительно темы успешного
старения.
Дискомфорт участия в этом опросе, как ожидают, будет немного. Однако, если Вы
действительно испытываете какой-нибудь дискомфорт, вы можете связаться со
Slavic Community Center, 2999 Fulton Ave, Sacramento, CA 95821, (916) 485-6410.
Никакой личный идентификатор не используется в этом опросе. Любая
информация, полученная в этом опросе, останется конфиденциальной.
Ваше участие полностью добровольно. Если Вы решите участвовать, Вы свободны
прекратить свое участие в любое время по любой причине.
Если у Вас есть какие-нибудь вопросы или комментарий в отношении этого опроса,
вы можете связаться c Ilona Timofey, timofeyi@yahoo.com, или с Dr. Francis Yuen,
fyuen@csus.edu.
Вам предложат копию этой формы.
Вы принимаете решение, участвовать ли. Ваша подпись указывает, что Вы
прочитали информацию, предоставленную выше, и решили участвовать. Вы
можете уйти в любое время без штрафа или потери льгот.
_____________________________________
Подпись
_____________
Дата
58
APPENDIX B
Successful Aging Questionnaire
59
SUCCESSFUL AGING QUESTIONNAIRE
Please do not put your name on this survey.
Please select the box after each question that best reflects your opinion. Thank you for your
participation.
Demographic Information:
1) Gender:
[ ] Male
[ ]Female
2) Age:
[ ]70-79
[ ]80+
[ ]Separated/Divorced
[ ]Widow [ ]Single
[ ]5-10 years
[ ]10+
[ ]60-69
3) Marital status:
[ ] Married
4) Number of years [ ]<5 years
in the U.S.A:
5) How is your English: [ ]Poor
(reading & writing)
6) Educational Status: [
[
[
[
[ ]Fair
[ ]Good
[ ]Excellent
]Finished H.S.
]College (Soviet Union)
]College (USA)
]Never attended school
7) Religious affiliation: [ ]Pentecostal [ ]Baptist [ ]Protestal [ ]No religion [ ]Other
8)
Whom do you live with?
[ ] Alone
[ ] With spouse
[ ] With immediate family
[ ] With relatives
9) Type of house you live in:
[ ]single house/duplex/apartment
[ ]Senior apartment complex
[ ]Care home facility
10) How often do you see any of your family members except people living with you?
[ ]Several times a week
[ ]About once a week
[ ]More often than once a month
[ ]Less often than once a month
11) I have [
[
[
[
]No close friends:
]Few
]Some
]Many
60
(SA=Strong Agree, A = Agree, D = Disagree, SD = Strongly Disagree)
SA
[ ]
A
[ ]
D
[ ]
SD
[ ]
13) I enjoy the time I spend with my friends: [ ]
[ ]
[ ]
[ ]
14) I know at least two of my neighbors by name:
[ ]Yes
[ ]No
12) I see my friends every day or two:
15) If I need assistance for daily chores, I feel comfortable asking my neighbors for help:
[ ]True
[ ]Not true
16) The daily activities that I enjoy most are:
1.
2.
3.
17) Physically I am:
[ ]Unhealthy
[ ]Somewhat unhealthy
[ ]Average
[ ]Healthy
18) I use medication to maintain my health:
[ ]Often
[ ]Sometimes
[ ]Always
[ ]Seldom
[ ]Never
19) I feel physical pain:
[ ]Often
[ ]Sometimes
[ ]Always
[ ]Seldom
[ ]Never
20) I visit my doctor:
[ ]Regularly
[ ]Rarely
[ ]Almost never
[ ]Sometimes
21) I currently have health insurance:
[ ]Yes
[ ]No
61
(SA = Strongly Agree, A = Agree, D = Disagree, SD = Strongly Disagree)
22) Mentally I am still pretty sharp:
SA
[ ]
A
[ ]
D
[ ]
SD
[ ]
23) I don’t forget about recent events:
[ ]
[ ]
[ ]
[ ]
24) I am a rather happy person:
[ ]
[ ]
[ ]
[ ]
25) I like helping people:
[ ]
[ ]
[ ]
[ ]
26) I talk to my friends about life challenges:
[ ]
[ ]
[ ]
[ ]
27) In general, feel satisfied with life:
[ ]
[ ]
[ ]
[ ]
28) I have done everything:
[ ]
[ ]
[ ]
[ ]
29) In my life I have achieved a lot:
[ ]
[ ]
[ ]
[ ]
30) I worry about my finances:
[ ]Often
[ ]Sometimes
[ ]Always
[ ]Seldom
[ ]Never
31) My financial situation is:
[ ]Very bad
[ ]Bad
[ ]Fair
[ ]Good
[ ]Excellent
32) My current income is:
[ ]Inadequate
[ ]Fairly adequate
[ ]Adequate
[ ]Very adequate
-----Thank You----Please return the questionnaire to the researcher
62
APPENDIX C
Interview Guide
63
Interview Guide
1. What are some of the things that you believe contribute to a successful aging
experience?
2. How would you define successful aging in America?
3. Is it easier to grow old in America than in your former home country?
4. What would make it better?
5. Do you think you are aging successfully?
6. What advice would you give young people on how to age successfully?
64
REFERENCES
Baltes, P.B., & Baltes, M.M. (1990). Psychological perspectives on successful aging: The
model of selective optimization with compensation. In P.B. Baltes & M.M. Baltes
(Eds.), Successful aging: Perspectives from the behavioral sciences. New York,
NY: Cambridge University Press.
Bowling, A. (2007). Aspirations for older age in the 21ST century: What is successful
aging?. International Journal of Aging & Human Development, 64(3), 263-297.
Casado, B.L., & Leung, P. (2001). Migratory grief and depression among elderly
immigrants. Social work practice with the Russian American Elderly, 36, 5-26.
Binghamton, NY: The Haworth Social Work Practice Press.
Crowther, M. R., Parker, M. W., Achenbaum, W. A., Larimore, W. L., & Koenig, H. G.
(2002). Rowe and Kahn's model of successful aging revisited: Positive spirituality
-- the forgotten factor. Gerontologist, 42(5), 613.
Deep, C.A., & Jeste, D.V. (2010). Successful cognitive and emotional aging.
Washington, DC: American Psychiatric Publishing, Inc.
Duay, D., & Bryan, V. (2006). Senior adults' perceptions of successful aging.
Educational Gerontology, 32(6), 423-445. doi:10.1080/03601270600685636.
Ferri, C., James, I., & Pruchno, R. (2009). Successful aging: Definitions and subjective
assessment according to older adults. Clinical Gerontologist, 32(4), 379-388.
doi:10.1080/07317110802677302.
Fitzpatrick, T. R., & Freed, A. O. (2000). Older Russian immigrants to the USA.
International Social Work, 43(3), 305.
65
Friedrich, D.D. (2001). Successful aging: Integrating contemporary ideas, research
findings, and intervention strategies. Springfield, IL: Charles C Thomas.
Hilton, J. M., Kopera-Frye, K., & Krave, A. (2009). Successful aging from the
perspective of family caregivers. Family Journal, 17(1), 39-50.
Hoffmann, C., McFarland, B., Kinzie, J., Breslev, L., Rakhlin, D., Wolf, S., et al. (2006).
Psychological distress among recent Russian immigrants in the United States.
International Journal of Social Psychiatry, 52(1), 29-40.
Lawler-Row, K. A., & Elliott, J. (2009). The role of religious activity and spirituality in
the health and well-being of older adults. Journal of Health Psychology, 14(1),
43-52. doi:10.1177/1359105308097944.
Leipzig, C. (2006). When Russians come to therapy. American Journal of Family
Therapy, 34(3), 219-242. doi:10.1080/01926180600550379.
Lim, D. (2008). Diverse city means diverse partnerships. Retrieved October 10, 2010,
from http://www.cityofsacramento.org/ns/news/documents/Aug08newsletter.pdf
Litwin, H. (2005). Correlates of successful aging: Are they universal?. International
Journal of Aging & Human Development, 61(4), 313-333.
McLaughlin, S. J., Connell, C., Heeringa, S. G., Li, L. W., & Roberts, J. (2010).
Successful aging in the United States: Prevalence estimates from a national
sample of older adults. Journals of Gerontology Series B: Psychological Sciences
& Social Sciences, 65B(2), 216-226.
McPherson, B.D. (1983). Aging as a social process: An introduction to individual and
population aging. Toronto, Canada: Butterswoths & Co.
66
Miller, A., & Gross, R. (2004). Health and depression in women from the former Soviet
Union living in the United States and Israel. Journal of Immigrant Health, 6(4),
187-196. doi:10.1023/B:JOIH.0000045256.45988.6a
Miller, A.M., Wang, E., Szalacha, L.A., & Sorokin, O. (2009). Longitudinal changes in
acculturation for immigrant women from the former Soviet Union. Journal of
Cross-Cultural Psychology May 2009 40: 400-415.
doi:10.1177/0022022108330987.
NASW. (1999). Code of Ethics. National Association of Social Workers. Washington,
DC.
Neuhaus, R.H., & Neuhaus, R.H. (1992). Successful aging. New York, NY: John Wiley
& Sons.
Phelan, E. A., Anderson, L. A., LaCroix, A. Z., & Larson, E. B. (2004). Older adults'
views of “successful aging”—how do they compare with researchers' definitions?.
Journal of the American Geriatrics Society, 52(2), 211-216. doi:10.1111/j.15325415.2004.52056.x
Phillipson, C. (1998). Reconstructing old age: New agendas in social theory and
practice. Thousand Oaks, CA: Sage Publications.
Pruchno, R.A., Wilson-Genderson, M., & Cartwright, F. (2010). A two-factor model of
successful aging. Journal of Gerontology: Psychological Sciences, 65B(6), 671–
679, doi:10.1093/geronb/gbq051.
67
Resick, L. (2008). The meaning of health among midlife Russian-speaking women.
Journal of Nursing Scholarship, 40(3), 248-253. doi:10.1111/j.15475069.2008.00233.x
Ron, P. (2007). Elderly people's attitudes and perceptions of aging and old age: The role
of cognitive dissonance?. International Journal of Geriatric Psychiatry, 22(7),
656-662. doi:10.1002/gps.1726.
Rossen, E. K., Knafi, K. A., & Flood, M. (2008). Older women's perceptions of
successful aging. Activities, Adaptation & Aging, 32(2), 73-88.
doi:10.1080/01924780802142644.
Rowe, J., & Kahn, R.L. (1998). Successful aging. New York: Pantheon.
Rubin, A., & Babbie, B.R. (2007). Essential research methods for social work. Australia:
Brooks/Cole, Cengage Learning.
Sadler, E., & Biggs, S. (2006). Exploring the links between spirituality and successful
ageing. Journal of Social Work Practice, 20(3), 267-280.
doi:10.1080/02650530600931757.
Seeman, T. E., & Berkman, L. F. (1995). Behavioral and psychosocial predictors of
physical performance: MacArthur studies of successful. Journals of Gerontology
Series A: Biological Sciences & Medical Sciences, 50A(4), M177.
Smyer, M.A., & Qualls, S.H. (1999). Aging and mental health. Belmont, CA: Blackwell
Publishing, Ltd.
68
Tran, T., Sung, T., & Huynh-Hohnbaum, A. (2008). A measure of English acculturation
stress and its relationships with psychological and physical health status in a
sample of elderly Russian immigrants. Journal of Gerontological Social Work,
50(3-4), 37-50.
Tran, T. V., Khatutsky, G. G., Aroian, K. K., Balsam, A. A., & Conway, K. K. (2000).
Living arrangements, depression, and health status among elderly Russianspeaking immigrants. Journal of Gerontological Social Work, 33(2), 63-77.
Weir, P. L., Meisner, B. A., & Baker, J. (2010). Successful aging across the years.
Journal of Health Psychology, 15(5), 680-687. doi:10.1177/1359105309353648.