Indian Journal of Gerontology

2015, Vol. 29, No. 2, pp. 154–169

Assessing the Life Satisfaction of Elderly

Living in Old Age Homes in the City of
Ahmedabad

Ambati Nageswara Rao, Yukthi Trivedi and Varushi Yadav

Department of Social Work, Gujarat National Law University,
Gandhinagar, Ahmedabad (Gujarat)

ABSTRACT
The present study was planned to find out the quality of life and the
coping strategies of the inmates of old age homes in the city of
Ahmedabad. 50 inmates (Male=33, Female=17) from five old age
Homes, were selected through the random sampling method. The
elderly subjects were interviewed individually to find out the
reasons for coming to live in old age homes and to know their views
about the living conditions and their coping strategy in the new
environment. The findings of this study revealed that the majority
of the elderly people did not get respect, love and affection from
their family members and were highly dissatisfied with the
behaviour their children. They were considered as a burden by the
family members. The respondents were of the view that in old age
when health deteriorates and person is unable to work his self
respect is badly hurt.

Key words: Elderly, Coping strategies, Isolation, Life satisfaction.

There has been a significant change in the Indian economy and

family system during the last five decades. Specifically, more and more
Indian joint families are turning into nuclear families. The nuclear
families are actually nothing but extended nuclear families with one or
Life Satisfaction of Elderly Living in Old Age Homes 155

more members related to the spouse or parents and grandparents

living in the family. Thus, the status of old age people has also changed
in the present family system. In the earlier days, the elderly members
were treated with regard for their experience and wisdom and
generally had the ultimate decision-making power in important family
issues. However, this situation is gradually changing for the worse for
the elderly persons, particularly; those who have retired from service
and other occupations. There are increasing numbers of instances of
such being emotionally, economically, mentally, and psychologically
isolated by their younger family members. Further, the feeling of
loneliness, along with the natural age related decline in physical and
physiological functioning, makes them more prone to psychological
disorders (Ghosh, 2006). In some cases, even elderly persons with
relatively rich families or aged persons who have nobody to look after
takes shelter in old age homes. These elderly have no alternative but to
live alone or away from their children.

Context of the Study

Changes in population structure will have several implications on
the health, economy, security, family life, well-being and quality of life
of the elderly. Quality of life is a holistic approach that not only
impacts the individuals’ physical, psychological, and spiritual
functioning, but also their connections with their environments; and
opportunities for maintaining and enhancing skills (Barua, 2007). The
process of ageing brings with itself the challenge of having to provide
care to a large number of older persons. Subjective quality of life can
defined in terms of well-being, happiness, and satisfaction, etc. satis-
faction with life is used in the sense of overall positive assessment by
the individual concerned (Anastasia, 2003).
The term ‘Life Satisfaction’ has been confused with the concepts
of happiness, psychological well-being, and adjustment. These terms
were used and prescribed by various scholars in different research
studies. The term life satisfaction is defined as “The way persons feel
about their daily activities, their responsibilities, the meaning of their
life, the achievement of goals, having a positive ego, regarding
themselves as valuable, and keeping an optimistic attitude” (Kim,
1996).
156 Indian Journal of Gerontology

Generally satisfaction is assumed and expected to decline in older

age; most notably as physical and health conditions deteriorate (Sung,
2003). The level of satisfaction of any individual is determined by
subjectively evaluating how much a person is satisfied with his own
life. The review of studies indicates that the factors of dimensions of
health, happiness of family, interrelationship with sons and daughters
and economic status of family have a great effect on the life satisfaction
of elderly people (Kim, et al., 1999; Park, 1988). The study of life satis-
faction in the elderly is an important subject of study because a
successful ageing process is regarded as an index of life satisfaction of
the old, but the study of the aged in institutions is still unsatisfactory
in the Indian context.
It was seen that many of the respondents living in ashrams or old
age homes took refuge in religion as a coping strategy. On the other
hand, the study by Ushasree (2009) indicates that those living in
ashrams without family member support were following non-religious
coping means to divert their minds from health problems than those
living with their family members. The study conducted by Das (2004)
brings out that there is a degree of concern for the elderly in the
country. This is reflected in the adoption of a recent National Policy
on Older Persons in 1999, which has identified principal areas of inter-
vention and action strategies. Although many legal aids are available to
these elderly people (like the old age pension schemes of Central and
State governments), the elderly, being a part of Indian society, which
emphasises on high moral values, love and affection, there are hardly
any provisions which enjoin upon the children to take better care of
their aged parents. No wonder, many elderly persons seek the support
and assistance of old age homes where the inmates are at least assured
of facilities like food, clothing, and shelter (UNFPA, 2012).
It is seen that the elderly in old age homes have poor adjustment
abilities compared to their counterparts who are still staying with their
family members (Minal and Kamala, 1995). Similarly, it was also
observed that feeling of loneliness is more in institutionalised elderly
people, whereas social support had a higher mean score for
non-institutionalised elderly people (Priya, 1998). At the same time,
the study by Srivastava (2002) indicates that in the different emotional
states the mean scores of anxiety, depression, and guilt of elderly
Life Satisfaction of Elderly Living in Old Age Homes 157

people living in institutions were higher than the mean scores on these
parameters of the elderly living with their children. As an interpre-
tation of these findings it may be said that elderly people who
demonstrate a tendency towards external locus of control have higher
level of satisfaction and vice-versa. This is mainly due to the fact that
elderly people who are externally focused and who have developed
trust in their health care provider actually demonstrate higher levels of
satisfaction than those who rely on themselves or depend on old age
homes. As a result the second group may experience more guilt or
feeling of hopelessness when faced with poor treatment.
In summary, review of studies on life satisfaction among old age
people have shown that emotional states like anxiety, depression and
guilt were more and social and emotional support were very less
among the elderly living in institutions.

Objectives of the Study

1. To find out the reasons behind elderly people leaving their
children and living in old age homes.
2. To assess the life satisfaction of elderly people living in old age
homes and the coping strategies adopted by them.

Methodology

Sample
The elderly people living in old aged homes of Ahmadabad
constituted the population of the research. Gujarat has a total of 57 old
aged homes out of which 10 are in Ahmedabad. After listing the
number of old age homes in Ahmedabad, the researchers randomly
selected 50 inmates (Male=33, Female=17) from five old age homes.
60 per cent elderly were living in ‘pay and stay’ type old age homes.
Their children were paying their expenses.

Method
A semi-structured interview schedule was used to find out the
views of respondents. These respondents were interviewed individ-
ually. The researcher took utmost care to make it as convenient as
possible for the respondents. In addition, the researchers were able to
explain or rephrase the questions if the respondents were unable to
158 Indian Journal of Gerontology

understand the questions. The respondents were put at ease by giving

them option of not answering the questions with which they were
uncomfortable. For analysing the data, the researcher used both
quantitative and qualitative data analyses. For analysing the quanti-
tative data, frequency, cross tabulations were used, while for analysing
the qualitative data, narrative analysis of the respondents were used.

Results and Discussion

Profile of the Respondents

The social demographic characteristics of the respondents are
presented in Table 1. The percentage of male and female respondents
was 66 and 34 respectively. The majority of the respondent’s (48%)
were in the age group of 66–70. Similarly, when the age category of the
respondents was related to their gender, it was found that there was
higher number of female respondents in the age group of 66–70 years
and less number in the age group of above 70 years as compared with
their male counter parts. Majority of the respondents of the study
were found to be hailing from urban areas.
Table 1
Demographic Profile of the Respondents

Variables Male (N=33) Female (N=17) Total (N=50)

n % (66) n % (34) n % (100)
Age 61–65 11 (22) 6 (12) 17 (34)
66–70 9 (18) 15 (30) 24 (48)
70+ 7 (14) 2 (4) 9 (18)
Caste General 07 (14) 03 (06) 10 (20)
OBC 19 (38) 12 (24) 31 (62)
SC 05 (10) 02 (04) 07 (14)
ST 02 (04) 0 (00) 02 (04)
Place of living Urban 25 (50) 12 (24) 37 (74)
Rural 08 (16) 05 (10) 13 (26)

Socio-economic Status of the Respondents

It was also seen that majority (36%) of the respondents had higher
secondary education. It was seen that proportion of graduate male
respondents was much more than that of their female counterparts.
Life Satisfaction of Elderly Living in Old Age Homes 159

The table also brought out that nearly 42 per cent of respondents were
having 6–9 members in their family, which indicates that majority of
them were from joint families. It was also seen that the majority (42%)
of respondents had worked in the public sector. As regards marital
status, 62 per cent of were married and 24 per cent, widowed. A very
negligible number of the respondents were unmarried. Similarly, it
was also observed that very few numbers of respondents were getting
more than Rs 3 lakhs salary per annual. Table 2 presents the distri-
bution of socio-economic status of the respondents.
Table 2
Socio-Economic Status of the Respondents

Variables Male (N=33) Female Total (N=50)

n % (66) (N=17) n % (100)
n % (34)
Educational status Primary 9 (18) 6 (12) 15 (30)
Secondary 7 (14) 11 (22) 18 (36)
Graduation 13 (26) 4 (8) 17 (34)
Marital status Married 24 (48) 11 (22) 31 (62)
Unmarried 5 (10) 2 (4) 7 (14)
Widow/or 7 (14) 5 (10) 12 (24)
No. of family members 2–5 09 (18) 03 (06) 12 (24)
6–9 14 (28) 07 (14) 21 (42)
10–13 08 (16) 04 (08) 12 (24)
14 above 02 (04) 03 05 (10)
Occupation Public 16 (32) 5 (10) 21 (42)
Private 13 (26) 2 (4) 15 (30)
Other 3 (6) 11 (22) 14 (24)
Income (Annually) Less than 1 Lakh 08 (16) 12 (24) 20 (40)
1 lakh to 3 Lakhs 16 (32) 05 (10) 21 (42)
Above 3 Lakhs 09 (18) 00 (00) 09 (18)

Reasons for Staying in Old Age Homes

Table 3 given below depicts the reasons for the respondents
staying in the old age homes. It can be seen that the largest number
(28%) of the respondents cited ‘Conflict with in the family’. The
second position was occupied by ‘Nobody to take care of them’ (24%),
160 Indian Journal of Gerontology

followed by ‘Family Feud’ (22%) and ‘Lack of Peace and health condi-
tions at home (18%). A very striking fact that emerged was that a
noticeable percentage (8%) of the respondents did not disclose the
reasons for their staying in these homes. This suggests the charitable
nature of such persons who, despite being cheated or ill-treated by
their younger relatives, were reluctant to speak ‘ill’ about them.
Maybe they were also reluctant to disclose embarrassing family secrets
to unknown.
Table 3
Reasons for Staying in Old Age Homes

Reasons to Stay Here No of Respondent’s % of Respondents

Conflict within the family 14 28
Lack of peace and healthy conditions at home 9 18
Family Feud 11 22
Nobody to take Care 12 24
Not disclosed 4 8
Total 50 100

Living and Health Conditions of Elderly at Old Age Homes

Table 4 brings out that the maximum numbers of elderly, i.e., 38
per cent, have been living in old age homes for a period between 1 to 2
years, followed by 36 per cent for less than 6 months and lastly the
smallest group comprising of 26 per cent member who are residing in
old age homes from 7–12 months. Majority of the male respondents
were staying alone in the old age homes as compared with their female
counterparts. The researcher found that in all the old age homes
studied, the nature of admission was not free but paid. The elderly
residing at these old age homes were required to pay a fixed amount
every month. This is a little amazing, because the elementary idea
behind setting up of old age homes is to provide free care to elderly
persons stranded without family care and support.
The table indicates that only 34 per cent of them were economi-
cally independent for their day-to-day expenses. This is mainly due to
the fact they were getting pension from government, while rest of
Life Satisfaction of Elderly Living in Old Age Homes 161

them were partially or completely dependent on either old age homes

or their children. The table also presents the health status of respon-
dents. The problems of hypertension, low vision, hearing and
Neurological problems, diabetics and other serious health issues were
72 per cent, 78 per cent, 64 per cent and 82 per centnstances respec-
tively. The prevalence of health problems was more among females, as
compared to males. Further, it was also identified from the respon-
dent’s narratives that majority of the respondents, i.e., 46 per cent,
sought treatment at hospitals while 27 per cent preferred were going to
clinics and the rest did not prefer to consult any one. This is mainly
due to lack of financial support from family members or the respon-
dents accepting their medical condition due to issues like old age.
Table 4
Living and Health Conditions of the Inmates of Old Age Homes

Variables Male Female Total

(N=33) (N=17) (N=50)
n% n% n%
Duration of stay < 6 months 13 (26) 5 (10) 18 (36)
7–12 months 9 (18) 4 (8) 13 (26)
1–2 years 11 (22) 8 (16) 19 (38)
Living With Spouse 7 (14) 5 (10) 12 (24)
arrangements
Alone 26 (52) 12 (24) 38 (76)
Economic Independent 12 (24) 5 (10) 17 (34)
dependence
Partly dependent 8 (16) 3 (06) 11 (22)
Dependent 7 (14) 15 (30) 22 (44)
Health status Hypertension 28 (78) 8 (22) 36 (72)
Low vision and hearing problem 22 (56) 15 (44) 39 (78)
Neurological problems 19 (59) 13 (41) 32 (64)
Diabetes and other health problems 26 (63) 13 (37) 41 (82)

Social and Emotional Support for the Elderly at Old Age Homes
An individual’s social support system comprises multiple
networks and various relations that include family, relatives, friends
and neighbours. The ageing experience of older people is largely influ-
enced by the degree they are embedded in social support networks.
162 Indian Journal of Gerontology

From the above Table, it can be seen that children of 48 per cent of the
respondents visit the old age homes on a monthly basis. A very
noticeable fact that emerged is that children of 22 per cent of respon-
dents do not visit them at all. A similar trend of ‘neglect’ was noticed
from close relatives – in nearly 60 per cent cases, no one was visiting
the inmates.
Table 5
Visits to Parents at Old Age Homes

Visits Visits to Parents at Old Age Home Total

Monthly Once in Special Not
a Week Occasions Visiting
Children’s visit 24 9 6 11 50
(48) (18) (12) (22) (100)
Close Relative visit 6 - 15 29 50
(12) (30) (58) (100)
Elderly visit to their Children homes 16 4 18 12 50
(32) (8) (36) (24) (100)

The above discussed the visits of children/close relatives to the of

old age homes. What was the trend about the elderly visiting the
homes of their children? A more positive picture emerged here. A
significant number of respondents stated that they visited on: special
occasions (36%) and on a monthly basis (32%). However, nearly 25 per
cent of the respondents were not visiting the homes of their children.
The study conducted by Zink, (1994) suggests that social support
becomes a significant source of help for older people, particularly
those living with chronic illnesses and acts as a buffer and alters
recovery patterns. However, the current study brings out a low level
of social support, care and emotional attachment of children with their
own parents. A major reason behind less frequent visits by the elderly
that the researchers came across was the apathetic nature or lack of
interest from the side of the children. They themselves are not too
concerned whether their parents come to see them or not. It was
understood from the narratives of respondents that many of them
opined that after a point in life the level of integration with their
siblings and extended family subsides, even when the elderly would
like to get more emotional support, but in practice their desires are not
Life Satisfaction of Elderly Living in Old Age Homes 163

fulfilled. It was also noted, some old age homes had fixed visiting
hours. However, in majority of the old age homes, there were no time
restrictions and relatives could come to visit anytime. Thus, restricted
visiting hours could not be cited as a reason for the children/close
relatives not ‘looking up’ the inmates more frequently.

Coping Strategies Used by Elderly People in Old Age Homes

The table given below presents the different coping strategies
being adopted by the respondents. The most popular strategies for
keeping a positive frame of mind were: meditation, worshiping god,
engaging in physical exercises, taking a rest or going on a vacation. It is
commonly believed that elderly tend to spend more time for religious
activities which provides a sort of social support in the form of
personal contact with other people at religious gatherings with whom
they could share their thoughts. Respondents, here, appeared to be
generally very pragmatic. This is evident from the low priority
accorded to escapist and fatalistic means like ‘Avoiding contact with
others’ (26%) and ‘Blaming one’s fate (18%). A very heartening feature
is the independent-mindedness exhibited by majority of the respon-
dents. This is evident from the relatively high priority accorded to
positive strategies: ‘Take a rest, go on a vacation (78%); ‘Double the
efforts to overcome the problem’ (74%); ‘Engage in vigorous physical
exercise and meditation daily’ (72%); ‘Talk about the issue to a family
member who can do something concrete about this’ (64%) and
‘Prepare yourself for the worst’ (56%). It may be said that the respon-
dents this study did not feel lonely in the environment of old age
home, since they were engaged in a multitude of tasks and using
various coping strategies in old age homes.
Table 6
Coping Strategies Used by Elderly People in Old Age Homes

S. No. Statements Yes (%) No (%)

1. Compare your problems with that of others and feel that 66 34
you are better off
2. Visit places of worship, go on a pilgrimage 58 42
3. Engage in vigorous physical exercise and meditation 72 28
daily
Cont’d…
164 Indian Journal of Gerontology

Cont’d…

4. Blame your fate; sometimes you just have bad luck 18 82

5. Come up with a couple of different solutions to the 44 56
problem
6. Avoid being with people, seek complete isolation 26 74
7. Prepare yourself for the worst to come 56 44
8. You know what has to be done. So you double your 74 26
efforts and try harder to make things work.
9. Talk to a family member who can do something concrete 64 36
about the problem.
10. Get away from things for a while; take a rest or a 78 22
vacation.

Life Satisfaction of Elderly at Old Age Homes

Life satisfaction among the elderly has become an important issue
in geriatric care. The review of research studies shows that it is affected
by various physical, emotional, social and mental conditions (Ko,
1995; Kim, 1996). The results of life satisfaction of elderly those who
are living at old age homes are presented in Table 7.
Table 7
Satisfaction of Life at Old Age Home

Age Category Satisfaction of Life at Old Age Home Total

Not Satisfied Neutral Satisfied
61–65 5 8 4 17
(30) (47) (23) (100)
66–70 8 10 6 24
(33) (42) (25) (100)
70+ 5 3 1 9
(56) (33) (11) (100)
Total 18 21 11 50
(36) (42) (22) (100)

It can be seen from the Table that, even on this parameter, there is
an overall tendency to accept things as they are, since the largest
number in the two age brackets 61 to 65 and 66 to 70, and overall, gave
‘Neutral’ response regarding their satisfaction levels. However, the
largest number of respondents in the above 70 years age bracket gave a
categorical ‘Not satisfied’ response on this issue. It is also noteworthy
Life Satisfaction of Elderly Living in Old Age Homes 165

that for all the age brackets, and overall, the ‘Not satisfied’ response
were more than the ‘Satisfied’ response. Even though most inmates
were not satisfied with the conditions in the old age homes, they are
forced to stay there, obviously for want of a better alternative. This
finding is in tune with that of Litwin and Shiovitz (2006) which
indicates that many of the elderly prefer to stay in old age homes,
despite their low level of satisfaction. This is mainly due to that fact
that many of them had stressful family relations and lack of family
care which forces them to seek ‘refuge’ in old age homes. Further, life
satisfaction is affected by their role in their family, their
socio-economic and health conditions, and the frequency of meeting
they have with their children living far away (Kim, 1996). Similarly,
studies conducted by Ko, (1995) and Meng, (1986) reveals that religious
activities also play an important role for life satisfaction of the elderly
people. Religious activities helps in finding new meaning to life and
gaining a positive attitude towards death and the loss associated with
old age.
Once it was established that most of the respondents stay in old
age homes since they had no other option, the logical question that
arose what about some of the positives they found in these ‘homes’.
One factor that emerged during personal interaction was that they
have the freedom to do what they want and to live as they wish and are
not bound by restrictions especially on their movements. Two, they
did not have to be dependent on the whims of family members. Three,
they felt they were being properly and adequately looked after and the
staff behaved properly with them. Yet another issue was having the
company of others belonging to a similar age bracket. This afforded
them the opportunity to discuss their problems and share experiences.
Thus, it emerged that the peaceful and positive ambiance at old age
homes was the reason behind their happiness. This arrangement
provides them the much needed comfort, solace stress free
environment, peace of mind and absence of conflicts, mostly with
their children.

Awareness about Government Policies

The Table below depicts the awareness level of respondents about
some of the policies that the government has come up with and
166 Indian Journal of Gerontology

implemented for the welfare of the elderly. It can be seen that the
majority of respondents were aware about the pension schemes
available for them, irrespective of whether they had earlier worked in
the private or public sector. Similarly, it could be seen that 54 per cent
of them were aware about various concessions available to them. Also
30 per cent were aware about the aid provided to old age homes. One
of the respondents was also aware of Maintenance of Senior Citizen’s
Act, 2007. According to this Act, it is the obligation of the children or
relative, as the case may be, to maintain a senior citizen, if the
concerned senior citizen is unable to maintain himself from his
earning or his property. This respondent informed that he was aware
of the Senior Citizen’s Act, since his own brother had successfully
used the provisions contained in the Act.
Table 8
Awareness About Government Policies

Awareness About Policies No of Respondent’s Percentage

Pensions 36 72
Concessions for elderly 27 54
Aid to Old age homes 15 30

Suggestions to Enhance Quality Life of Elderly in Old Age

Homes
The respondents gave diverse suggestions on how the quality life
of the elderly could be improved. The maximum number of them
suggested that regular or frequent visitors would help in enhancing the
dignity and quality life of the elderly. Visitors need not only be family
members, but could also include people who come to visit because
they feel attached to the elderly persons, even though they may not be
related to them. A particular mention was made of school and college
children who they can talk to alleviate their loneliness. It is pivotal to
understand that it is through the support of others, the elderly are able
to rebuild and sustain their sense of dignity in their changed circum-
stances.
Some of them also suggested that people must not look down
upon them. Elderly are perceived as the dependent lot of society
Life Satisfaction of Elderly Living in Old Age Homes 167

because as they age, they require physical, mental and emotional care
and support. It is about time people changed their psyche as elderly
not only can take, but also provide/give their enriching lessons and
experience. A few respondents stated that if people start to put
themselves in their position (empathising with them), it would help in
increasing their quality of life because ageing and related problems are
not in anybody’s control. People need to understand that they too will
age as some time later in life.
Thus, the suggestions of respondents indicate that care, support
and understanding can enhance the quality of life or dignity. They also
opined that elderly must put into practise their freedom of speech in
every matter to prove that they are not silent sufferers. It shows that
they had a pessimistic outlook and did not want to suggest ways that
could help in enhancing their quality of life as they felt nothing could
be done to improve it.
Finally the study revealed that the most common reasons for the
respondents staying in old age homes was that they could not look
after themselves or there was no one to take care of them. In fact, this
is, in a way, a forced choice. Another reason was the conflict with
children or with other family members. The most common purpose
reported for preferring institutional living arrangement was to seek
peace of mind here since, familial affection was denied to them by their
children/close relatives. It is saddening to note that the decision of
majority of respondents was not their own, they did not come out of
their own free will. Living in old age homes gave a positive and homily
feeling to majority of respondents of this study. They were happy
because they have made friends and enjoyed being in the company of
co-inmates. On the other hand, the efforts of government are not very
effective, because a significant number of respondents (28%) revealed
that they were not aware of any policy. Pension scheme was the only
scheme that was known to the respondents. Respondents informed
that they never felt the need to be abreast of government policies.
In conclusion, it can be said that with an increase in materialism
in the contemporary society and an inclination towards the western
world, there is a change in traditionally preserved and followed values.
Now an increasing number of children, instead of considering taking
care of their parents as a responsibility, see them as ‘disposable’
168 Indian Journal of Gerontology

burdens. We as a society have moved forward and surely emerged as a

better place to live in, but we must not forget the values that our
forefathers left behind for us. It is, therefore, a sad reflection that these
expectations of the elderly for care and comfort from their children
remain unfulfilled. The results, therefore, suggest that the state should
be prepared to meet the need for good institutional living arrange-
ments for the elderly as the demand for such care is likely to rise in the
future. Simultaneously, some sort of counselling services will also need
to be developed and incorporated in the larger programmes for the
elderly to address their psycho-emotional and physical health.

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