Stress coping mechanisms in elderly adults: an initial study of recreational and other coping behaviors in nursing home patients.(Report)

Residents (N = 32) of 3 skilled nursing homes participated in a study designed to document the nature of the stressors they experienced and the coping mechanisms they used. Medical issues were the most common stressors. The most common coping responses were prayer, reading, watching television, listening to music, and talking to friends and family.

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By 2050, with the aging of the baby boomers, the population of persons age 65 years and older will be approximately 70 million, or 1 in every 5 Americans (Hooyman & Kiyak, 2002; Pratt & Kethley, 1988). Accompanying this demographic change are ever increasing concerns for the quality of life experienced by elderly adults. The custodial model, whereby elderly adults were merely warehoused in nursing homes, is now seen as inappropriate. Medical science, along with various societal changes, has provided more individuals with the opportunity to live to an advanced age, maintain their health, and experience high levels of perceived wellness (Myers & Degges-White, 2007; Peterson, 1999).

However, aging is related to a number of factors that have a detrimental effect on the quality of life. These include declining health (Boardman, 2004; Kola & Kosberg, 1981; Stones & Kozma, 1984), loss of friends and family members (Glantz, 1981; Stones & Kozma, 1984), employment and financial problems (Eckenrode, 1984; Pearlin & Radabaugh, 1976), alienation from the larger society (Frytak, Harley, & Finch, 2003; Pearlin, 1983; Pearlin, Schieman, Fazio, & Meersman, 2005), and loneliness (Brown & Chiang, 1983; Schonfeld & Dupree, 1991; Stroebe & Stroebe, 1996; Victor & Scarf, 2005). As a consequence, some elderly adults experience unacceptable reductions of life satisfaction. Bickerstaff, Grasser, and McCabe (2003) wrote: "Some elderly persons seem to cope with inevitable changes of later life with a spirit of acceptance. ... Unfortunately, losses of later life can prove to be overwhelming for many older adults" (p. 159).

Perceived quality of life is a complex phenomenon. Often, while comparing two individuals with similar life circumstances, investigators find considerable disparity in reported quality of life. Robinson (1973) pointed out that antecedents to quality of life can be classified either as primary factors or process factors. Quality of life primary antecedent factors that are commonly identified include physical and emotional safety, financial security, health, self-concept and self-esteem, and social engagement factors. The process factors that influence quality of life are personal attributes that contribute to the interpretation of the primary factor antecedents. The existence of process factors explains why two people subject to similar objective conditions can have grossly dissimilar perceived levels of life satisfaction (Robinson, 1973; Sekaran, 1983).

Pearlin (1989) found that stressful experiences could be traced to social structures and an individual's role within those structures. He described two types of stressors: life events observed through the quality of nonnormative change and chronic stressors rooted in institutionalized roles* Both types of stress are of critical concern for elderly adults; however, chronic stressors, and their relationship to institutionalized roles, are especially important considerations because many elderly adults experience more stressors, perceive higher levels of stress, and have fewer effective coping responses available to them than do adults at other times of life (Brown & Chiang, 1983; Chiriboga, 1984; Seeman, Seeman, & Budros, 1988; Stones & Kozma, 1984).

Recreational activities serve as both common stress buffers and stress coping responses. Recreational behavior plays a role in an individual's stress-related symptoms (Cassidy, 1996; Trenberth & Dewe, 2002). However, some functional recreational coping mechanisms are lost by elderly adults because of advancing age; for example, as they age, many people experience medical conditions that preclude high physical-impact recreational alternatives. Moreover, some dysfunctional coping responses, such as alcohol abuse, are also recreational in nature. Researchers do not know if recreation-as-coping plays an increasingly important role as one ages; it is obvious, however, that elderly adults need diversified portfolios of successful coping mechanisms, and recreational activities often constitute a major opportunity to adopt those mechanisms.