Perceptions of Well-Being in Two Groups of Older Adults: Long Term Care Center Residents and Non-Residents, in Curico, Chile
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PERCEPTIONS OF WELL-BEING IN TWO GROUPS OF OLDER ADULTS: LONG TERM CARE CENTER RESIDENTS AND NON-RESIDENTS, IN CURICO, CHILE By CAROLA SALAZAR A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY UNIVERSITY OF FLORIDA 2017 © 2017 Carola Salazar To Mamá, Papá, and Isidora ACKNOWLEDGMENTS Like every dissertation, this is a product of the work and support of many people. First, I thank to my committee: Susan Bluck, Alyson Young and Lance Gravlee. Their support and suggestions during every stage of my academic formation was key to this research. Thanks especially to Peter Collings, chair of my committee and mentor, for his continuous help since I started my master’s degree back in August 2012, when I was a barely English speaker with lots of questions and concerns. In addition, thanks to the staff from the department of anthropology, for their help. Also, the people that helped me in Chile: Vanessa Marín, from SENAMA, who helped dealing with all the bureaucracy process. José Poblete from the Programa de Adulto Mayor in Curicó. María Beatriz and María Clara from the ELEAM, and especially to señora Carmen Martínez from UCAM. And to each one of the 50 older adults that trusted in me and told me their stories, especially to Pascual and Susanita. I am so happy for learning so much from them, including a lot of things that goes far beyond the academic learning. This research is also dedicated to the memory of the late Adriana Iturriaga, a respondent who died while I was conducting the second phase of this research. I also want to dedicate this dissertation to both of my grandmothers: Jana and Yolanda, for showing me how different old age can be lived. In addition, I want to thank my parents and sister, for all their loving support during these five years living so away from them, and their extra support while I was conducting research in my hometown, Curicó. Thanks mom and dad for the rides, and your guidance when I was trying to do as much work as possible during three months. Also, thanks to my sister, Isidora, who despite being 14 years old back then, helped me to systematize the quantitative data. Finally, infinite thanks to my fiancé Felipe, for his 4 unconditional support during these five years of graduate school, and life away from our friends and family. Despite being in the same chaotic situation, he stood by my side and helped to make this possible. 5 TABLE OF CONTENTS page ACKNOWLEDGMENTS .................................................................................................. 4 LIST OF TABLES .......................................................................................................... 10 LIST OF FIGURES ........................................................................................................ 11 LIST OF ABBREVIATIONS ........................................................................................... 12 ABSTRACT ................................................................................................................... 13 CHAPTER 1 INTRODUCTION .................................................................................................... 15 2 UNDERSTANDING AGING IN CONTEXT: THE LIFE COURSE PERSPECTIVE AND THE STUDY OF WELL-BEING AMONG OLDER ADULTS ........................... 24 Life Course ............................................................................................................. 26 Theoretical Orientation ..................................................................................... 26 Applications in Aging Studies ........................................................................... 32 Well-Being .............................................................................................................. 36 “The Good Life” ................................................................................................ 36 Applications in Aging Studies ........................................................................... 39 3 CHILE: AN AGING COUNTRY ............................................................................... 45 Demographic Transition in Chile ............................................................................. 47 Impacts on the Chilean Society ........................................................................ 50 Impacts on Families and Households ............................................................... 52 Impacts on Social Contract ............................................................................... 56 Chilean Older Adults......................................................................................... 59 Aging and the Social Safety Network ...................................................................... 61 Pension Systems .............................................................................................. 63 Health Care ...................................................................................................... 65 National Service for Older Adults (SENAMA) ................................................... 66 Living Arrangements for Older Adults ..................................................................... 67 Independent Living ........................................................................................... 68 Collective Residences ...................................................................................... 68 Predictors of institutionalization .................................................................. 69 Faith-Based institutions .............................................................................. 70 ELEAM: long-term care centers ................................................................. 72 Chilean Cultural Views of Older Adults ................................................................... 75 Chilean Identities .............................................................................................. 75 Abuelitos: Older Adults as Synonym of Grandparents ..................................... 76 6 4 WELL-BEING IN ADULTOS MAYORES: CURICÓ AS A CASE STUDY ............... 79 Well-being in Chilean Adultos Mayores .................................................................. 81 Family as a Main Source for Social Support ..................................................... 81 Volunteering and Participation in Organizations ............................................... 82 Home Ownership .............................................................................................. 84 Psychological Factors....................................................................................... 84 Income.............................................................................................................. 86 Curicó ..................................................................................................................... 87 Location ............................................................................................................ 87 Historic Background ......................................................................................... 88 Geography and Economic Activities ................................................................. 89 Demographic Profile ......................................................................................... 90 Adultos Mayores in Curicó ................................................................................ 91 Options for Dependent Adultos Mayores ................................................................ 92 ELEAM in Curicó .............................................................................................. 92 ELEAM Carmen Martínez Vilches .......................................................................... 93 Approach .......................................................................................................... 93 History .............................................................................................................. 94 Location and Capacity ...................................................................................... 96 Administration ................................................................................................... 98 Admission ......................................................................................................... 99 Options for Independent ....................................................................................... 100 Sporadic Activities .......................................................................................... 100 Clubes De Adulto Mayor in Curicó ................................................................. 100 Approach ........................................................................................................ 101 Club De Adulto Mayor “Estrellitas Del Vaticano” ................................................... 102 Club De Adulto Mayor “Campo Lindo” .................................................................. 102 5 ADDRESSING WELL-BEING IN CHILEAN OLDER ADULTS THROUGH SURVEYS ............................................................................................................. 105 Admission of a New Resident at the ELEAM ........................................................ 105 Foreword ............................................................................................................... 109 Addressing Well-Being in Adultos Mayores