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CHAPTER 5

SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS

Is it possible today to have the kind of community where older adults can stay in their rural communities, know and help each other as an extended family, experience a feeling of security, come together for social activities, and share a common interest in maintaining their living space?

Summary

Older adults in rural communities want to stay in their home communities where their children were raised, land was tilled, lifetime friends remain, and sense of "home" exists. However, housing in rural America remains a concern. Many older adults express a desire to live in their own homes but services are not always available and many homes are not safe or functional for older adults in aging years. Housing for older adults in rural communities remains a dilemma and influences the quality of life of these same older adults. Rural cooperative housing is a housing alternative for older adults and this study provides a foundation and a framework for communities examining this option.

The older adult population has tripled since 1900 and the most rapid increase is predicted to occur between the years 2010 and 2030 when the "baby boomers" reach 65. This suggests that the American population is getting older and the number increasing at a rapid pace. The demand for more and better housing options has surfaced as a major older adult issue. Alarmingly, there is little evidence that adequate senior housing options have increased appropriately.

Improving the living environments of older adults is underway in some states. However, several gaps in the knowledge and research on the living environments of older adults remain untouched. Stevens-Long and Commons (1992) indicated that at the time of the writing of their book, Adult Life, no correlational research existed on satisfaction of elderly living in conventional, condominium, cooperative, or mobile housing. Studies of housing projects and developed communities suggest that life satisfaction and social behavior are positively correlated to one's environment. Research incorporating housing and a physical health variable have shown contrasting results; positive effects and no evidence of improvement (Dorfman, Heckert, Hill & Kohout, 1988; Hong & Duff, 1994; O'Brien, Hassinger & Dershem, 1994). Satisfaction with home is distinct from, but related to attachment to place; the way in which lives and environmental features are subjectively intertwined (Stevens-Long and Commons, 1992). Research is beginning to identify the variables that relate to home and quality of life.

Purpose and Objectives of the Study

The problem of providing viable, functional housing options contributing to quality living for the older rural adults continues to be an intractable and crucial question. It invites much attention and requires serious consideration for older adults in their aging years, the communities involved in providing living communities for their older adult population, and the political arena committed to the policy making of older adult housing issues. The purpose of this study was to describe the quality of life of older adults living in rural cooperative housing. The following objectives were identified to lend direction and strength to several interests currently being explored:

1. Identify the reasons why older adults choose to move to cooperative housing.

2. Describe the effects living in rural cooperative housing has on older adults.

3. Describe the personal characteristics of older adults living in rural cooperative housing.

4. Determine the quality of life of the HOMESTEAD residents.

The argument in support of the research--the quality of life of older adults living in rural cooperative housing-- offers many implications in older adult research. Identifying the variables that correlate to quality of life helps gerontologists predict the future social and life temperament of the older adult population. Will cooperative living facilitate satisfying retirement years for older adults? When the rural dimension is introduced, will the issue of where to house rural older adults come into play? These questions will be concerns older adults, gerontologists, community developers, and policy makers will need to explore in integrating rural older adults into local communities, increasing the quality of life, maintaining social structures, encouraging independence, and preserving "rurality".



Procedures and Methods

This study used a descriptive qualitative and quantitative research design that examined the quality of life of older adults living in rural cooperative housing. It examined relationships and identified the qualities that existed among a set of variables within a population of older adults. Seven rural older adult cooperative housing units exist in the United States and each belonged to the same cooperative organization-- HOMESTEAD Housing Centers. A list of HOMESTEAD residents was secured from the HOMESTEAD Housing Center, Inver Grove Heights, Minnesota. The mailing list was comprised of 163 individuals comprising a homogeneous, census population of older adults living in rural older adult cooperative housing. All older adults with a HOMESTEAD residence were included in the study. A 93% response rate (N=151) was obtained after four mailing waves.

Focus group interviews were conducted with residents at HOMESTEAD, St. James and HOMESTEAD, Springfield. All residents at these two sites were invited to participate in focus group interviews: 38 accepted the invitation. Focus group interviews were initiated prior to the sending of the mail questionnaire.

A mail questionnaire was designed and tested for reliability and validity. The instrument was tested for stability by test-retest reliability to determine if the same results were obtained from the same subjects over a period of time. Content validity was assessed by a panel of experts and final instrument reflect revisions.

Three themes were addressed in the questionnaire: housing, quality of life, and personal characteristics. Questions 1-6 requested information about previous housing. Question 7-9 related to whether respondents liked or disliked rural cooperative housing and if they would recommend cooperative housing to other older adults. Questions 10-21 addressed factors that influenced the decision to move to HOMESTEAD housing and these eleven questions were summated to acquire a "Cooperative Value" which was utilized in the data analysis. A "Quality of Life" value was obtained by summating questions 22-30 which surveyed quality of life issues. Questions 31, 32, and 44 were open-ended questions inviting the respondent to express what they liked most, least, or general comments about HOMESTEAD living and their quality of life.

Conjectures for the study were made based on the descriptive statistics and the compilation of the focus group interview scripts. Pearson product-moment correlations were calculated to determine the amount and direction of relationships between selected variables.

Major Conclusions

Data analysis was summarized by research objective and the major conclusions are reported in the same format as in Chapter 4.

Objective 1: Identify the reasons why older adults choose to live in cooperative housing. It was evident that the older adults were not attracted to these cooperative communities because they were concerned about their frailty or because they were greatly dissatisfied with their previous homes. In fact, many of these HOMESTEAD residents did

not have intolerable housing problems. But a complaint consistently shared throughout the interviews and on the mail questionnaires was the oversized home that was too expensive, time consuming or exhausting to maintain. For once in their lifetime these older adults were free to choose a late-in-life home meeting their personal, social, and psychological needs.

The variable that surfaced as the main influencing factor in selecting cooperative housing was "easier maintained home". This result paralleled the findings in a study by Lawton and Hoover (1981) on community housing choices for older Americans. In addition, but not to the degree, variables "staying in the community"; "help close by"; "handicapped accessible"; "better financial investment"; and, "voice in the operation" all had a major influence in the housing selection process. Other studies addressing housing decisions for the aging population in rural America provided similar results (Rowles, 1983; Coward & Lee, 1985; Stevens-Long & Commons, 1992; Bull, 1993).

Re-occurring themes in the focus group interviews were "quest for an easier life", "home-free maintenance", and "cooperative spirit". Statements that reflected these themes were:

" ... It's comforting to know that my home maintenance is taken care of. I own my home and I don't have to work so hard at taking care of it."

" ... You do things cooperatively here and it cost less. We could not afford to live in a place like this individually; but, cooperatively we can. There are 16 of us paying for snow removal, lawn care, electricity, utilities, cable TV, etc. Jointly, we pay a ridiculous low rate."

The attraction to these smaller size, easier-to-maintain, cost efficient homes allowed the older adults to remain active and independent in their home community. The disengagement and activity aging theories lend support to this conjecture on housing selection for older adults. The disengagement theory proclaimed older adults were happiest and most successful when they acknowledged their declining capabilities and began to prepare for their last stage of life. Whereas, the activity theory assumption was to remain an active, independent player in the latter years of life.

Overwhelming agreement occurred among the HOMESTEAD residents when a fellow resident exclaimed, "HOMESTEAD is more than a type of housing; we are building a community. It is a style of life!" The key to fostering a sense of community is to provide places where neighboring can occur naturally (Kane & Monk, 1991). Neighboring at HOMESTEAD occurred where people were attracted on a regular basis such as mailboxes, community room, hallway and entrance to the facility.

Objective 2: Describe the effects living in rural cooperative housing has on older adults. The quality of life was assessed for the older adults living at HOMESTEAD.

Several variables showed an effect on the life quality of the cooperative residents: safety, happiness, life satisfaction, friend contact, ease in maintaining home, activities, and independence. The focus group interviews revealed similar responses:

" ... I have lived in this community for many, many years. I feel comfortable here. It is where my friends are. Your children can move several times and be so far away, but my friends, they remain here with me."

" ... We are a sociable group here and many of us have so much in common. "

" ... My neighbors are my extended family; they take care of me and look after me."

" ... I am completely satisfied with my life. It's the best living we've ever had. Ever had, and I thought we were comfortable before we lived in here but it's nothing compared to this. No, people say, it's tough to get old; but, at no time in our life have we ever had it any better."

Studies based on existing theories and findings in gerontology support these findings (Havighurst, Neugarten, & Tobin, 1968; Palmore, 1970; Duff & Hong, 1982, 1993). These theories contended that variables such as community context, quantity and/or quality of social interactions are vital to the life satisfaction of older adults.

Older adults in age-segregated settings literally create their own world surrounded by others who value their worth and are more sensitive to the growing old process (Roscow, 1967). The HOMESTEAD communities attended to each other's needs and wants. Health problems came to the attention of neighbors with conversation such as "Grace was feeling tired yesterday; we will need to stop by this afternoon to see if she is okay."

An age-homogenous housing option, similar to HOMESTEAD, allows older adults the opportunities for friendships with persons having similar life concerns and backgrounds. However, caution must be made not to assume all individuals 65 years and older are similar. Certainly a 65 year resident will have differences in life style when compared with his 85 year old neighbor.

Objective 3: Describe the personal characteristics of older adults living in rural cooperative housing. The profile demographics of the residents of HOMESTEAD are 69% female, 46% married, 43% with a salary between $20,000 - $39,999 and an education level of high school or higher (62%). Forty-eight percent lived in their previous home at least 26 years within 12 miles of HOMESTEAD (83%). This latter characteristic reinforced the theoretical models on community attachment. The linear-development model (Kasarda & Janowitz, 1974) theorized population size and population density are key variables in community attachment. The systemic model (Park & Burgess, 1921; Janowitz, 1967) emphasized the length of residence, position in the social structure, and stage in life were influencing factors in the community attachment theory.

Objective 4: Determine the quality of life of the HOMESTEAD residents. The quality of life dimension among the HOMESTEAD residents boasted high scores. The mean score was 6.7 with a standard deviation of 2.7. Sixty-eight percent scored a quality of life value between 4.0 and 9.4.

The cooperative dimension, likewise, scored high among the subjects of the study. This dimension measured the variables influencing the decision to select cooperative housing. The mean score of 11.9 and standard deviation of 5.0 indicates that 68% of the respondents scored a cooperative value between 6.9 and 16.9.

The focus group interviews showed strong relationships between the cooperative living component and the quality of life component with such statements like:

" ... I think the main reason we moved here was because we knew sooner or later we were going to lose our spouse. This is an ideal place to continue to live a pretty normal life."

" ... My story is about like Vivan's. I was out on the farm, you know and just couldn't handle getting to town in the wintertime so then I talked to the real estate agent here and he said HOMESTEAD was going to be built, I signed up for it right away."

" ... We are all growing old together here at HOMESTEAD and liking it - I thought I would never say that!"

The studies on age-segregated housing lend support to these findings. Factors such as independence, friendships, services, and safety often surfaced as high indicators of life satisfaction among the older adult residents in age-segregated housing (Sherman, 1972; Lawton & Cohen, 1974; Carp, 1975; Malozemoff, Anderson & Rosenbaum, 1977; U.S. Department of Housing and Urban Development, 1979; Chellis, Seagle & Seagle, 1982; Golant, 1985; Hinrichsen, 1985). Golant (1982) suggested that retirement communities offered their occupants a relatively unchanging, ordered, and predictable setting and life-style. Therefore, the sense of certainty HOMESTEAD offers may be valued highly, especially in a society perceived as rapidly changing and sometimes intolerant of its older adult population.

Future Research Prospects and Potential Implications for Extension Education

  • Rural cooperative housing for older adults is a relatively new concept and has stimulated little research. Future research, therefore, needs to address the implication rural cooperative housing has on older adults over time.

  • There has been research confirming the positive effect of age-segregated housing on quality of life. The type of research now needed should address changes in life quality over a longer period of time. Longitudinal studies will provide this data base.

  • Yet another researchable issue is the effect of varying degrees of homogeneity among residents at housing sites. Homogeneity may relate to demographics, independence, or health and poses the question--does this diversity among older adults complicate the quality of life issue?

  • A longitudinal study may be beneficial to examine the maintenance of social relationships in age-segregated housing and if there is any impact on the quality of life among these social systems.

  • If, in fact, more age-segregated housing becomes available for the aging population, what will be the implications on future housing patterns? Demographers show a plateau and then a decline in older adult population once the baby boomers progress through the aging process.

  • There is a need for more comparison research focusing on the life quality variables of older adults living in cooperative housing versus more traditional housing options.

  • Does the "rurality" issue play a vital part in housing older adults in rural America? Further research needs to focus on the community attachment component and how it relates to rural older adults.

  • If older adults seek living options away from their rural communities, what implications will this have on maintaining the older leadership structures and the stability of the rural America. Research can focus on the benefits of aging in place and how it relates to the community development issues, intergenerational issues, and agricultural issues.

  • A thorough examination of research tools must be made to insure age-sensitivity and the absence of ageism. Future research could confront these two major concerns and the relationship they have on reliable and valid research. Are there separate ageism and age sensitive constraints with rural versus urban populations?

  • Further research needs to be directed to the rural older adult populations. If in fact, rural older adults do have stronger life satisfaction when allowed to "age in place", what implications does this have for care givers, community developers and older adults.

  • Research should be conducted examining the family and social ecosystem relationships on the rural cooperative housing issue. Are relationships strengthened when older adults voluntarily select age-segregated housing?


    Recommendations

    Future housing for rural older adults should take into consideration the needs of the current generation of the "young-old", "middle-old" and "old-old" adult population. Housing policy and programs for older adults have tended to get less attention than income security and health care. There are a number of reasons to explain this phenomenon. From one perspective, an adequate income should make it possible for an individual to select suitable housing or maintain existing housing. From another perspective, many older adults may and do live with relatives, so that housing is not an urgent need to be met. The trend is to improve the quality of life among older adults by addressing their housing needs through existing communities and neighborhoods rather than through the experimentation of new housing concepts (Newcomer, Lawton & Byerts, 1986).

    Quality of life for rural older adults does present some implications. Is it possible to measure a construct so complex? This researcher thinks yes if we continue to respect its complexity. Although financial well-being, independence, and good health have repeatedly shown direct correlations with one's quality of life, other factors such as adequate housing, social networks and community services also surface as important (Nelson, 1980; Rubenstein, 1989; Pastalan, 1990).

    Although gerontologists, community developers, and older adults sometimes disagree among themselves as to the model living arrangement for the aging population, they all tend to agree that certain characteristics for older adult housing are necessary for the improved quality of living in their home communities: access to community, medical, and recreational services; safe and secure environment; privacy; and social interaction. A five mile proximity of community services deemed most important by older adults choosing housing alternatives were a church, shopping area, restaurant, and common area for socializing (Nolan & Nolan, 1996).

    Will cooperative housing for the older adult be the wave of the future in rural America? Probably not. But to many in rural Minnesota and rural Iowa it is the quality of living they had hoped for in their aging years. Reasons to move into housing for the older adult or retirement community often center around concern with one's ability to continue to cope with the demands of regular housing or, at the least, a disinterest in spending one's time in such pursuits (Lawton & Hoover, 1981). The decision to move is focused on trading off a certain amount of freedom plus a considerable amount of drain on one's energy and time for a place that can care for the person at varied levels depending on the individual's ability, wants and desires; but yet still maintain control of one's environment. In other words, the cooperative housing concept attracts individuals or couples because what it offers to rural communities is not generally available elsewhere. Safety, security, social interaction, independence, and freedom from maintenance chores are predominant benefits gained from cooperative housing.

    The older adults living in rural cooperatives expressed a feeling of being pushed away from their previous housing due to the feeling of danger, worry about being unnoticed if in trouble, social isolation, pressing housing issues, and environmental demands. In any case, the choice is being made to go to a housing situation that is more nurturing; where both the resident and the housing corporation merge together in the care process of each partner. HOMESTEAD residents reported a better quality of life (66%) when compared to their previous home; 94% would recommend HOMESTEAD housing option; and 98% would move to HOMESTEAD if making the decision again.

    On the flip side, many older persons do not want to be identified as among the old; nor do they want to be continually surrounded only by persons of their own age. They associate old age with a loss of social status, low prestige, low self-esteem, and incompetence (Roscow, 1967). The following statements suggested this view from some segments of the local communities surrounding HOMESTEAD:

    " ... people think HOMESTEAD is some sort of nursing home."

    " ... some people say, those people at HOMESTEAD have too many cliques and no outside interests."

    A question that needs to be addressed but answers are yet to be determined: how long will the cooperative concept be the appropriate choice for its residents? The concept is relatively new and in only the third year of operation at HOMESTEAD. This study revealed that 70% of the HOMESTEAD residents lived previously in a small town or farming community within 12 miles of HOMESTEAD (82%) for at least a period of 26 - 40 years (45%). Findings support the two theoretical models of community attachment: the linear-development model and the systemic model. The linear-development model (Kasarda and Janowitz 1974) indicated population size and population density as key variables in determining community attachment. Whereas, the systemic model (Park & Burgess 1921; Janowitz, 1967) emphasized length of residence, position in the social structure, and stage in the life cycle as important variables in community attachment. A considerable number of studies on older adult satisfaction have focused on the comparison between quality of life and community attachment to city, suburban, or rural areas. More recent studies have documented that community attachment does influence later life decisions and the well-being variables among older persons (Klein, 1993; Hong & Duff, 1994; O'Brien, Hassinger, & Dershem, 1994).

    Once one moves into a cooperative housing situation, he or she may not remain independent or in good health. An issue in an age-specialized facility is that the general, average level of health and personal competence declines over time. Therefore, does this housing option for the older adult allow one then to age in place? The answer to these concerns are, not surprisingly, "yes and no". For many older adults, their personal competence levels never decline below a point that remains in a match with those living in the same location (Stevens-Long & Commons, 1992). However, there may become a point in time when an individual can not remain "in place" depending on the characteristics of the place. At HOMESTEADS, an assisted-living care is not available. Sooner or later, it may be necessary to relocate to an environment with another level of service.

    The main objective in the research study is that, yes, there is a positive quality of life among the older adults living in rural cooperative housing. This housing option does satisfy some very important physical, social, and psychological needs for this segment of the older adult population (Figure 3-1).


    Whatever forms older adult housing projects take, they share many similar characteristics:


    Summary

    In summary, further research needs to be directed to the rural older adult populations. The argument in support of the research - are there correlations between the factors that influence rural older adults to select rural cooperative living and quality of life variables - offers many implications in older adult research. Identifying the variables that correlate to quality of life helps gerontologists predict the future social and life temperament of the older adult population. Will cooperative living facilitate satisfying retirement years for older adults? When the rural dimension is introduced, will the issue of where to house rural older adults come into play? These questions will be concerns older adults, gerontologists, community developers, and policy makers will need to explore in integrating rural older adults to local communities, increasing the quality of life, maintaining social structures, encouraging independence, and preserving "rurality".


    " ... I was born here in Springfield and I am going to die here in Springfield!"

    " ... We are growing old gracefully with all our friends. What a Life!"

    " ... Mom absolutely loved HOMESTEAD and wished she had gone long before she did rather than staying alone on her farm. It is a wonderful housing concept. She has recently died; but, I am comforted to know her last few years of life were so enjoyable!


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