School of Health and Social Services

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    Satisfaction with life and social comparison among older people : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Health Science at Massey University, Manawatu, New Zealand
    (Massey University, 2015) Rodgers, Vivien Kaye
    Introduction: In a rapidly greying world, successful ageing is an important concept and goal. While this remains poorly-defined in the literature, there is wide agreement that satisfaction with life is a major contributor, together with health and functional ability. It has been suggested that the perception of satisfaction with life might be affected by social comparison, but little is known about this relationship, particularly among older people. Consequently, this study investigates the impact of health-related and social comparison variables on the perception of satisfaction with life at various stages of old age. Methods: A cross-sectional survey of 542 community-dwelling people aged 65+ was conducted to measure health (physical and mental), functional ability, satisfaction with life and social comparison dimensions. Participants were randomly selected from the general electoral role of the Manawatu region of New Zealand. The Short Form-12 Health Survey measured perceived physical and mental health, the Groningen Activity Restriction Scale measured functional ability, the Satisfaction With Life Scale measured life satisfaction and the Iowa-Netherlands Comparison Orientation Measure assessed social comparison. Additional demographic information was collected. Age groups (65-74, 75-84, 85+) were compared. Results: A marked difference was found in satisfaction with life before and after age 85 years, that was not explained by health (physical or mental), functional ability, demographic factors or comparison frequency. The oldest participants (aged 85+) consistently reported the highest levels of satisfaction with life. This same group reported predominantly making downward social comparisons (with those doing worse). Conclusions: Important links were found between satisfaction with life and downward social comparison. Better understanding of comparison drivers across older age will progress the discussion on what impacts the perceptions of satisfaction with life and contributes to successful ageing.
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    Successful ageing : a critical analysis : a dissertation submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in the School of Sociology, Social Policy, and Social Work at Massey University, Palmerston North, New Zealand
    (Massey University, 2006) Holmes, Jeanne
    The demographics and implications of the growth of the world's population of older people have been well publicised. Frequently, this is linked to concerns about growing demands for social services. In liberal western nations, this rise in the proportion of elderly people is occurring at a period in history when governments are attempting to contain state spending on health care and welfare. Within this context, the gerontological concept of 'successful ageing', which encourages productivity and self-reliance among older people, has emerged. The term 'successful ageing' was coined by R. J. Havighurst in 196l and developed by Rowe and Kahn into a gerontological concept in 1998. Rowe and Kahn's search to identify the factors "that conspire to put one octogenarian on cross-country skis and another in a wheelchair" led them to put forward the view that 'successfully aged' old people are those who remain healthy and socially engaged. The concept of successful aging is widely regarded as promoting well-being in old age. As a result, it has become highly influential in the fields of nursing, social work, and social care. However, the concept has also attracted criticism, mainly for praising the fortunate and privileged elders who have managed to prolong healthy middle age; whilst labelling unwell, disabled, and lonely old people as unsuccessful. In this thesis, my central criticism of the concept of successful ageing is that its definition of 'success' in old age is not based on the views and real life experiences of older people, but instead, on the expertise of scientists and researchers, many of whom have yet to experience the decline and losses normally associated with old age. Consequently, there is a significant difference between the concept of successful ageing and a proportion of elderly people regarding the requirements for the best possible old age. The purpose of this study is to discover the factors which a diverse group of old people regard as essential to optimal old age. It compares and contrasts their self-assessed components of well-being with the externally assessed components of 'successful aging'. The process involved in-depth research with thirty elderly people in New Zealand and the United States. The majority were women. Several ethnic groups were represented. Participants included First Nations people, first generation immigrants, and the descendants of European settlers. Although it was not intentional, my entire sample consisted of people who would have been defined as unsuccessfully aged by the 'successful ageing' paradigm. Yet these people showed resilience, resourcefulness, and often, great satisfaction with their lives. This research demonstrates that there is an incomplete fit between the factors, which older people say produce the best possible old age, and those promoted by the concept of successful ageing. It concludes that in order to promote optimum well-being among older people, it is necessary to take note of the experiences, views, and values of elders themselves.
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    Senior citizens? : old age and citizenship in provincial New Zealand communities : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy at School of Sociology, Social Policy and Social Work, Massey University
    (Massey University, 2002) Kerr, Alison Lassie
    This research considers the extent and quality of the citizenship of older New Zealanders in the "Third Age", a stage in the adult life cycle between the second age of careers, partnership and parenting and the fourth and final phase of (usually) increasing dependency. The study questions: whether 'senior citizens' have access to the material and cultural resources to enable them to choose between different courses of action in their daily lives; whether existing intergenerational relations enable them to appropriate substantive rights and responsibilities; and what are the relational practices and processes, the networks and affiliations, through which citizenship may be 'performed' by older people? This research was carried out with six groups of elderly people in a range of communities in the province of Hawke's Bay on the East Coast of the North Island of New Zealand. The purpose of running six different focus groups, each over a six week period, was to generate discussion of the issues for older people as well as individual stories about the lives of elderly people in particular local communities. The aim was to investigate the meaning of old age for elderly New Zealanders by critically analysing the term 'senior citizen'. The study built on contemporary theories of ageing and citizenship, using a narrative collective life history approach in order to focus on older people's personal experience of policy, and the capacity for citizenship that they bring with them into old age. The study also identifies national and local government policies, national and local organisations, media representations of old age, local communities, families and the attitudes of elderly people themselves as important influences on the extent to which they are able to exercise and enjoy their rights and responsibilities as senior citizens. My central thesis is that senior citizenship depends on a civil society which supports autonomy and connectedness for all its citizens. The balance between these two aspects of citizenship is culturally determined and sensitive to outcomes in a range of social domains over the life span. Recommendations focus on self-determination and social inclusion for older people through anti-ageist policies and practices at the national and the local level, and further research into the plans and aspirations of senior citizens.
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    Delirium in the older adult : a critical gerontological approach : a thesis presented in fulfilment of requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand
    (Massey University. School of Health Sciences, 2005) Neville, Stephen John
    The purpose of this thesis has been to explore the discursive production of delirium in people over the age of 65 years. The philosophical approaches underpinning the study were derived from the field of critical gerontology, postmodernism and the utilisation of a Foucauldian understanding of discourse and power/knowledge. Data sources included published documents on delirium, interviews with people over the age of 65 years who had been delirious (as well as their clinical notes), family members, registered nurses and a doctor.Textual analysis revealed the presence of two contesting and contradictory discourses that impacted on being an older person who had delirium. These were identified as the discourse of delirium as a syndrome and a personal discourse of delirium. The discourse of delirium as a syndrome is underpinned by the biomedicalisation of the ageing process. This process utilises scientific methods as the foundation from which to understand, research and provide a health service to older people with delirium. Any personal perspectives on delirium are rendered unimportant and relegated to marginalised positions. Nursing through its vicarious relationship to medicine is interpellated into deploying the discourse of delirium as a syndrome and has largely ignored the personal dimensions associated with this phenomenon. Consequently, the older delirious 'body' is known and inscribed as unruly, problematic, physically unwell, cognitively impaired and at risk.Conversely, a personal discourse of delirium privileges the individual narratives of people who have been delirious and provides a different perspective of delirium. The deployment of a personal discourse of delirium offers another position that views this group of older people as bringing to the health care setting a rich tapestry of life experiences that are more than a cluster of signs and symptoms. It is these varied life experiences that need to be included as a legitimate source of knowledge about delirium. This thesis demonstrates how nursing needs to espouse a critical gerontological position when working with older people who have delirium. Critical gerontology provides nurses with the theoretical tools to challenge the status quo and uncover the multiple, varied, contradictory and complex representations of delirium in older people.