Social Support in Elderly Nursing Home Populations: Manifestations and Influences

The purpose of this study was to describe the characteristics of social support and the influencing factors on social support in nursing home environments. Observations and staff questionnaires from two central Florida nursing homes were used in this grounded theory study to answer the following questions: (1) How is social support manifested? and (2) What are influences on social support? Social support manifestations seemed predominantly superficial and did not appear to involve complex reciprocal relationships, however, when reciprocal resident tasks were observed, they appeared to have significant value and were sources of pride for the residents. Facility behaviors and policies required by governmental mandates appeared to result in significant resident dependency, a situation that mitigates against significant social support. Key Words: Social Support, Nursing Home, and Elderly ********** In the year 2040, 77 million Americans will be over the age of 65 (Stone, 1999). Since an estimated 1,465,000 people over the age of 65 occupied nursing homes on any given day in 1997 (Gabrel, 2000), a large number of this aging population will undoubtedly require some type of long-term care. Recognizing the generalized perception of substandard quality of life in nursing homes, the Institute of Medicine recommended in 1985 that residents should be cared for in such an environment as will promote maintenance or enhancement of their quality of life. (Uman et al., 2000, p. 167) Repeatedly researchers have reported on the health benefits resulting from social support (Cohen-Mansfield, 2000; Lee, 1985; Siebert & Mutran, 1999). According to Atchley (2000), social support consists of people we can count on to provide ongoing emotional support, affirmation, information, and assistance, especially in times of crisis. Interestingly, nowhere is the enormity of the impact of social support potentially more critical than in the institutionalized elderly. Purpose The purpose of this study was to identify the characteristics of social support and the influencing factors on social support in a nursing home environment. Analysis of the social support dynamics within these long-term care or nursing home settings, particularly the relationships between residents, and the meanings and characteristics of these relationships, as well as the influences on social support, may potentially contribute to increased holistic and resident-centered services and perhaps enhanced resident well-being. Literature Review Definition of Social Support Atchley's (2000) aforementioned definition of social support is a broad definition of social support. Other academic theoretic definitions add that the recipient should have a perception of someone caring for them and a resultant sense of well-being (Hupcey, 1998). Hupcey enumerated the factors required for social support as follows: (a) the act of providing a resource, (b) the recipient having a sense of being cared for or a sense of well-being, (c) the act having an implied positive outcome, (d) the existence of a relationship between the provider and the recipient, (e) support not given from or to an organization, the community, or a professional, and (f) support that does not have a negative intent or is given grudgingly. Given these constraints, it is unclear as to whether social support is present in cases of critically ill, incoherent recipients, in cases of negative outcomes in which either the recipient or provider perceive the support actions as positive, in support given from or to an organization, the community, or a professional, and in support that has a negative intent or is given grudgingly. In order for social support to yield maximum life satisfaction benefits, it must include the ingredient of reciprocity (Lee, 1985). Reciprocity involves mutual sharing or giving and helps to sustain self-worth. …