Loneliness and Anxiety About Aging in Adult Day Care Centers and Continuing Care Retirement Communities

Abstract

Background and ObjectivesThe present study compares how 2 settings: adult day care centers (ADCCs) and continuing care retirement communities (CCRCs) fare with regard to loneliness and anxiety about aging. Loneliness is a highly prevalent and distressing subjective experience of inadequate social relations, which has negative effects on health and well-being. Anxiety about aging is defined as worries brought up by imagining the negative consequences and losses associated with old age. The study also examines whether anxiety about aging accounts for differences in loneliness between the 2 settings. This study took place in Israel, where ADCCs are funded by the National Insurance Institute of Israel and CCRCs tend to be funded by private income and wealth. Despite notable differences between the settings, a common goal of both is to reduce loneliness among older adults.Research Design and MethodsA cross-sectional design of 4 ADCCs and 4 CCRCs (N = 456).ResultsCompared with CCRC residents, older adults in ADCCs reported higher levels of loneliness (Mean [SD] = 1.46 [0.60], Mean [SD] = 1.78 [0.80], respectively, t [df]= −5.10 [448], p < .001) and higher levels of anxiety about aging (Mean [SD] = 2.96 [0.88], Mean [SD] = 3.27 [0.99], respectively, t [df] = −3.42 [440], p < .001). Anxiety about aging partially accounted for the differences between the 2 settings in levels of loneliness (B = 0.03, 95% confidence interval [CI]: 0.0037–0.0651).Discussion and ImplicationsAlthough it is not possible to determine causality from this cross-sectional design, it is possible that CCRCs provide a better social outlet for older adults than ADCCs.

From a Bird’s Eye View: Whole Social Networks in Adult Day Care Centers and Continuing Care Retirement Communities

“…Given the significance that intimate relationships play in older adults’ lives ( Carstensen et al, 2003 ), it appears that CCRCs are better capable of moving older adults from large secondary groups, to more intimate primary groups ( Olk & Gibbons, 2010 ; Perion & Steiner, 2017 ). This finding is consistent with a recent study which has found higher levels of loneliness among ADCCs’ users compared with CCRC residents ( Ayalon, 2018 ). Hence, it appears that compared with ADCCs, CCRCs are better at facilitating more intimate social interactions between older adults.…”

“…First, the study relied on four ADCCs and four CCRCs. Although this represents a substantial number of different settings, given the very limited research on the topic conducted thus far ( Ayalon, 2018 ), to fully explore the network structure as a whole and draw firm conclusions about it, a larger number of settings is desired. The nonresponse rate in our study was similar to the nonresponse rate reported in several other studies with difficult to reach populations ( Casey, Low, Jeon, & Brodaty, 2016 ; Locker, 1993 ), yet, it certainly limits the information one can infer about the social network ( Kossinets, 2006 ).…”

“…The present analysis, “from a bird’s eye view,” is one of the first studies in the field of gerontology to use quantitative social network analysis (SNA) to describe the structure of different long-term care settings ( Ayalon, 2018 ). This allows for an appreciation of the unique characteristics of each of the settings as a whole.…”

Younger and Older Adults’ Mood and Expectations Regarding Aging During COVID-19

“…Unfortunately, negative attitudes about aging are related to a variety of health outcomes in older adults, including lower survival rates and physical and mental health issues ( Breda & Watts, 2017 ; Han & Richardson, 2014 ). Anxiety about aging can even explain some of the relationship between one’s environment and loneliness ( Ayalon, 2018 ), suggesting that negative aging attitudes could exacerbate feelings of loneliness (see also Shiovitz-Ezra et al, 2018 ). On the other hand, positive attitudes about aging have been associated with more new friends in older adulthood ( Menkin et al, 2017 ), which could prevent loneliness.…”

Sense of belonging to the community in continuing care retirement communities and adult day care centers: The role of the social network

“…That study concluded that ADCCs are therefore, ineffective in alleviating loneliness (Iecovich & Biderman, ). A different study comparing loneliness in ADCCs and CCRCs has found higher levels of loneliness (Ayalon, ), as well as sparser networks and lower social reciprocity in ADCCs (Ayalon, Yahav, & Lesser, ). CCRC residents on the contrary, have generally reported substantial social benefits associated with their relocation into the CCRC (Ayalon & Greed, ).…”