ENVIRONMENTAL MOBILITY FOR THE ELDERLY: A SURVEY STUDY IN SARDINIA (ITALY)

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1 ENVIRONMENTAL MOBILITY FOR THE ELDERLY: A SURVEY STUDY IN SARDINIA (ITALY) Veronica Cerina, Ferdinando Fornara CIRPA:Centro Interuniversitario di Ricerca in Psicologia Ambientale Dipartimento di Psicologia Sapienza Università di Roma, Università degli Studi di Cagliari ffornara@unica.it Abstract: The present study examined i) what conditions have the strongest positive effects on the attitude to relocate of the elderly and on perceived well-being, and ii) what is the role of place attachment in influencing the decision to change their residential environment. A sample of 192 individuals older than 65 years filled in a questionnaire including several measures of both psycho-social dimensions and socio-physical characteristics of the settings. Results showed that environmental competence is a significant predictor of elderly well-being and attitude to relocate, the latter being also influenced by home attachment and context of residence (i.e., rural residents are more prone to move than urban residents). Further differences characterize rural residents with reference to urban residents in terms of perceived well-being, environmental competence, collective identity, and motivations to relocate. Keywords: elderly well-being, relocation attitudes, motivations to relocate, place attachment, environmental competence Introduction The progressive and rapid aging of the world population, with an increasing proportion of older people living longer than previous generations, can be considered today one of the most important and epoch-making processes, and rates very high, especially in industrialized countries. According to a recent report by United Nations, today Italy is one of the countries with the highest levels of longevity and, considering European Union countries, with the highest percentage of over-sixty-five. Referring to the other EU countries, another noteworthy fact is that Italian residential facilities for older adults need to be developed yet, despite their considerable frailty and needs for services and care (Mortilla e Monorchio, 2007). In order to satisfy such needs, it is frequent the recourse to family support: unlike other countries, about 65% of care to older people at home are provided by informal intervention, and the presence of domestic care workers or minders is very high (Salvioli, 2007). For older people without a good network of relationships or adequate personal resources, daily time spent in solitude in their homes seem to be a very frequent condition. In all these cases, a relocation would be preferable and necessary. 238

2 Scientific literature on relocation shows conflicting results. Most empirical studies, mainly conducted in the U.S. context, focused on the analysis of the negative effects of relocations (especially non-voluntary) on well-being of individuals, and showed that older people who spend their later life at home on one side evaluate the quality of their life much higher than those who are faced with a relocation, and on the other side they preferred to remain in the family context of their own home (Blenkner, 1967; Scanlon & Devine, 2001; Challis & Davies, 1985; Callahan, 1992). On the contrary, other studies showed that a relocation, although initially feared, may have for the older person a very positive impact on her/his health, especially on the areas of autonomy, social relations and overall quality of life (Nygren & Iwarsson, 2009; Oswald, Schilling, Wahl, & Gäng, 2002). Differences about aging in different contexts (rural vs. urban), especially as regards autonomous behaviour, social relationships, psychological satisfaction, self-perception of general health and quality of life have been examined by Paùl, Fonseca, Martìn, & Amado (2003). Most relevant results of their study were differences between rural and urban residents in some sociodemographic characteristics, in their level of autonomy (higher in rural elderly), in their social network (larger for rural elderly) and in their attitudes toward their own aging (more positive in rural elderly). At present there is a substantial lack of recent studies, especially in the European context, that identify what conditions have the strongest positive effects on attitude to relocate and what can be done to improve residential settings for older people from a health and well-being perspective. Environmental mobility, in place or prospected, can be, especially for older people, a complex experience, in a both cognitive and affective perspective, thus it is necessary to consider the role of a large number of psycho-social-environmental dimensions (such us needs, expectations, environmental competence, attachment to places) and of socio-physical characteristics of the settings (referred to the context of origin or destination) on attitudes towards environmental mobility and perceived quality of this experience. Objectives and hypotheses The conceptual frame of reference of this study is the Complementary-Congruence Model of person-environment fit (Carp & Carp, 1984) that is based on Murray s (1938) notion that adaptation depends on satisfaction of personal needs by the environment. This model tries to explain relevant changes in person-environment relationship during the life-span, with particular attention to the processes of ageing. According to the model, fit between individual needs and characteristics of the environments is a predictor of several outcomes, such as physical and 239

3 psychological wellbeing, satisfaction, autonomy, and so on. Outcomes may be modified or mediated by other intrapersonal characteristics (sense of personal competence, coping style, etc.), extrinsic situations (status resources/deprivation, social support, etc.), and life events. Starting from the model of Carp & Carp (1984), the main purposes of the present study are to identify i) what conditions have the strongest positive effects on the attitude to relocate of the elderly, and ii) what is the role of an affective pattern like place attachment in influencing the decision to change their residential environment. The operational hypotheses were as follows. H1. It is expected a significant correlation between environmental competence and psychological well-being. H2. It is expected that context of provenience, type of identity, prevalence of relocation motives related to satisfaction of basic or high-order needs and environmental competence will influence attitude to relocate to a residential facilities for older adults. H3. It is expected a significant correlation between attachment to home and attitude to relocate in elderly people. Method Participants The study participants (N=192, 97 females and 95 males) were over-65 aged individuals, with a mean age of 74 years and a standard deviation of 6.9 years. The sample was composed as follows: 99 participants lived in urban contexts (with more than inhabitants) and 93 were rural residents (in contexts with less than inhabitants). All the participants were living independently in their homes (61% with the spouse, 25% alone) and the majority of them (74%) didn t need any kind of care (in about 20% of the cases they received informal care and in only 2% they received formal care). Tools and procedures Subjects that accepted to participate were interviewed using an instrument that was heteroadministered. Almost all the interviews took place at the elderly people s house, but also in squares and public gardens, and each interview took about 50 minutes. 240

4 The instrument contained the following scales: a) attitudes to relocate to a residential facility for older adults, for both a brief and a long period, 10 items. The rating scale was a 5-step Semantic Differential-type scale and the respondents were asked to choose were his/her position lied on a scale containing a list of 5 bipolar items (for example, pleasant-unpleasant, happy-sad, necessary-unnecessary ); b) home attachment, 3 items (adapted from Fornara, Bonaiuto, & Bonnes, 2010). The response scale was a 5-step Likert-type scale (from totally disagree to totally agree ); c) psychological well-being, 5 items (adapted from the ones used by the Osservatorio delle Politiche Sociali della Provincia di Lucca, 2008), referred to health, parents, social relationships, psychological serenità and life in general. The response scale was a 5-step Likert-type scale (from totally unsatisfied to totally satisfied ); d) perceived environmental competence, 4 items (adapted of Williams, Freedman, & Deci, 1998). The response scale was a 5-step Likert-type scale (from totally false to totally true ); e) personal and collective identity 6 items (adapted from Oishi, Lun, & Sherman, 2007),. The response scale was a 5-step Likert-type scale (from totally unrelevant to totally relevant ); f) motivations to relocate, 9 items (Oswald, Schilling, Wahl, & Gäng, 2002). The response scale was a 5-step Likert-type scale (from totally false to totally true ); g) socio-demographic indicators such as age, gender, education, profession, marital status, context of living and eventual need of care. Data analysis The following data analyses were performed: a) Principal Component Analyses and internal consistency compute (Cronbach s Alpha) in order to check respectively for the monofactorial structure and the internal coherence of the scales;. aggregate scores were then computed for each factor; b) a hierarchical regression with attitude toward a relocation into a residential facility (an aggregate score of attitude toward brief and long relocation) as criterion and three sets of 241

5 predictors: relocation motives (related to satisfaction of basic needs, of anticipation of basic needs and of high-order needs), personal identity and collective identity at step 1; home attachment, perceived well-being and environmental competence at step 2; context of residence (urban vs. rural) at step3. c) a simple linear regression with perceived well-being as criterion and home attachment, environmental competence and context of residence as predictors; d) one way ANOVAs with the context (urban vs. rural) as IV and the psycho-social factors as DVs. Results Outcomes of the PCA and reliability analyses show acceptable psychometric properties for all the scales, with Cronbach s Alphas ranging from.82 to.65(see Table1). Table 1. Psychometric properties of the scales SCALES FACTORS % OF EXPLANED VARIANCE N OF ITEM Attitude toward brief relocations ATTITUDE BRIEF Attitude toward long relocations ATTITUDE LONG Home attachment ATTACHMENT Perceived well-being WELL-BEING Perceived environmental competence COMPETENCE Prevalence of personal identity PERSONAL IDENTITY ΑLFA Prevalence of collective identity COLLECTIVE IDENTITY Relocation motives related to the satisfaction of basic needs MOTIV. BASIC NEEDS Relocation motives related to the MOTIV. ANTICIP. OF BASIC satisfaction of anticipated basic needs NEEDS Relocation motives related to the MOTIV. HIGH-ORDER satisfaction of high-order needs NEEDS Table 2. Hierarchical regression of predictors on attitude to relocate to a residential facility for elderly people CRITERIA: Attitude Regression Coefficients 242

6 Step 1 Step 2 Step 3 MOTIV. BASIC NEEDS MOTIV. ANTICIP. OF BASIC NEEDS MOTIV. HIGH-ORDER NEEDS -.23* -.21* -.09 PERSONAL IDENTITY COLLECTIVE IDENTITY.23*.18*.04 HOME ATTACHMENT ** -.23*** WELL-BEING COMPETENCE -.25*.23** URBAN/RURAL *** R Square R Square Change * *** *** N=192 ***: p<.001 **: p<.01 *: p<.05 The final hierarchical regression model with attitude toward relocation as criterion revealed a significant variation with respect to step 2 (see Table 2). Among predictors, home attachment and context of residence were significantly correlated to attitude to relocate (p<.001), the first one negatively. Also environmental competence was a significant predictor of attitude to relocate (p<.01), whilst both relocation motives related to satisfaction of high-order needs and collective identity were significant at step 1 and step 2 (p<.05), turned out to be non-significant at step 3. The simple linear regression of perceived well-being on home attachment, environmental competence and context of residence revealed that only environmental competence is a strong and significant (p<.001) predictor of well-being (see Table 3). Table 3. Linear regression of predictors on perceived well-being Dependent variable: well-being Regression Coefficients ATTACHMENT.08 COMPETENCE.27*** URBAN/RURAL.11 R Square F(3,188) *** N=192 ***: p<.001 **: p<.01 *: p<

7 Finally, there are several differences between elderly people resident in urban contexts and elderly people resident in rural contexts, as it is shown in Table 4. Table 4. Main differences between rural and urban residents Urban M/SD Rural M/SD F(1,190) Sign. MOTIV. BASIC NEEDS 3.35/ / MOTIV. ANTICIP. OF BASIC NEEDS 3.80/ / n.s. MOTIV. HIGH-ORDER NEEDS 3.84/ / PERSONAL IDENTITY 3.01/ / n.s. COLLECTIVE IDENTITY 3.35/ / ATTACHMENT 4.55/ / n.s. WELL-BEING 3.56/ / COMPETENCE 3.42/ / Most relevant differences concern relocation motives, that are significantly higher in urban elderly, especially those related to satisfaction of high-order needs (F=22.432, p<.001), and those related to satisfaction of basic needs (F=4.287, p<.05). As far as prevalent type of identity is concerned, the collective identity is more predominant in rural elderly (F=26.789, p<.001). Finally, rural elderly show a higher perceived well-being (F=5.846, p<.05) and a higher sense of environmental competence (F=6.499, p<.05) than urban elderly. Discussion and conclusions On the whole, research hypotheses were confirmed by the outcomes. First, environmental competence seems to play an important role in influencing perception of well-being: the more the elderly people perceive their capacity to adapt themselves to different places, the higher they will judge their level of well-being. This finding provide also empirical evidence to the assumption of Steverink, Westerhof, Bode, & Dittman-Kohli (2001), who have pointed out that the most important psychological resources elderly people have are perception of self-efficacy and of competence in exercising control on their environment, and that, similarly, even the subjective sense of their own health can be considered as one of the best predictors of how well they cope with their physical decline in order to realize a successful aging. 244

8 Second, in older adults the attitude to relocate to residential facilities seems to be influenced by the context of provenience: urban residents seems to express a more negative attitude toward a possible relocation than rural residents. Attitude to relocate seems to be influenced also by home attachment: the stronger the attachment, the more negative is the attitude toward a relocation. Also environmental competence seems to positively influence attitude to relocate: the more elderly people perceive their capacity to adapt themselves to different types of environments, the more they will be willing to relocate to a facility, especially if they expect to find a residential structure with characteristics of comfort, attractiveness and response to personal desires (motives related to satisfaction of high-order needs). On the contrary, the hypothesis that personal and collective identity influence attitude to relocate in a significant way did not find empirical support in this study. In conclusion, it is to stress the need of further research in order to deepen the complex relationships among the psycho-social dimensions involved in the elderly attitudes towards their relocation. References Blenkner, M. (1967). Environmental change and the aging individual. Gerontologist, 7, Callahan, J. J. (1992). Aging in place. Generations, 16, 5-6. Carp, F.M., & Carp, A. (1984). A Complementary/congruence model of well-being or mental health for the community older. In I. Altman, M.P. Lawton & J.F. Wohlwill (Eds.), Human Behavior and Environment, Vol. 7: Older People and the Environment. New York, London: Plenum Press, (pp ). Challis, D., & Davies, B. (1985). Long term care for the older: The community care scheme. British Journal of Social Work, 15, Fornara, F., Bonaiuto, M., & Bonnes, M. (2010). Cross-validation of abbreviated Perceived Residential Environment Quality (PREQ) and Neighbourhood Attachment (NA) Indicators. Environment & Behavior, 42, Mortilla, E., Monorchio, A. (2007). Rapporto Nazionale 2007 sulla Condizione ed il Pensiero degli Anziani. Ageing Society-Osservatorio Terza Età, Roma. Murray, H.A. (1938). Explorations in personality. New York: Oxford. Nygren, C., & Iwarsson, S. (2009). Negotiating and effectuating relocation to sheltered housing in old age: a Swedish study over 11 years. European Journal of Aging, 6,

9 Oishi, S., Lun, J., & Sherman, G.D. (2007). Residential Mobility, Self-Concept, and Positive Affect in Social Interactions. Journal of Personality and Social Psychology, 93(1), Osservatorio delle Politiche Sociali della Provincia di Lucca. (2008). Il benessere degli anziani. Rapporto 2007 sulla condizione della popolazione anziana in Provincia di Lucca. _2008.pdf Oswald, F., Schilling, O., Wahl, H.W., & Gäng, K. (2002). Trouble in paradise? Reasons to relocate and objective environmental changes among well-off order adults. Journal of Environmental Psychology, 22, Paùl, C., Fonseca, A.M., Martìn, I. & Amado, J. (2003). Psychosocial Profile of Rural and Urban Elders in Portugal. European Psychologist, 8(3), Salvioli, G. (2007). Gli anziani e le badanti. Giornale di Gerontologia, 55, Scanlon, E., & Devine, K. (2001). Residential mobility and youth wellbeing: Research, policy, and practice issues. Journal of Sociology and Social Welfare, 28, Steverink, N., Westerhof, G. J., Bode, C., & Dittmann-Kohli, F. (2001). The personal experience of aging, individual resources and subjective wellbeing. Journal of Gerontology: Psychological Sciences, 56B(6), Williams, G. C., Freedman, Z. R., & Deci, E. L. (1998). Supporting autonomy to motivate glucose control in patients with diabetes. Diabetes Care, 21,