Symbolic Interaction Analysis: Activity Theory

Unlike theories that hold older adults need to disengage from society, the symbolic interactionist framework posits that social interaction and activity have a positive effect on the health and well-being of this segment of the population. Activities considered helpful under this theory include informal activities (such as social interaction with family and friends), formal activities (participation in group functions), and solitary activities (including such pastimes as reading or watching television). A number of empirical studies have found that older individuals who are active using the above criteria tend to be happier, have higher self-esteem, and report a better quality of life than their peers. This widely held theory has been used to inform numerous programs for older adults in nursing homes and other venues. However, although activity theory appears to have wide applicability, it is still not supported by the depth of research necessary to fully understand the complex relationship between activity and social interaction on the one hand and the health and well-being of older adults on the other.

Keywords Activity Theory; Baby Boomer; Bridge Job; Correlation; Disengagement Theory; Empirical; Functionalism; Interview; Quality of Life; Regression Analysis; Social Interaction; Status; Symbolic Interactionism

Overview

Many aging adults face retirement not with resignation but with eager anticipation of changing careers, taking up a new hobby, engaging in a long-postponed avocation, or otherwise engaging life in new and different ways. Still others continue to work at their job or as a freelancer or take a bridge job until they are ready for retirement. In fact, statistics show that post-retirement employment has been increasing over the past several years. Aging adults are not ready to give up and disengage. Even those older adults who do retire from their careers and do not get another job have not necessarily retired from life or disengaged from society. Many merely are changing their focus and becoming more actively involved in other activities, interests, or with family.

Senior citizens are a rapidly growing segment of the population in the United States. In the years between 1900 and 2000, the number of individuals aged sixty-five years and older in the United States grew from 3.1 million to 35.0 million. Of these, the population aged eighty-five and older has experienced the greatest growth, growing by 38 percent from 3.1 million to 4.2 million during the 1990s alone (Schaefer, 2002, p. 277). According to 2012 estimates by the US Census Bureau, nearly 14 percent of Americans are older than sixty-five. Now that members of the baby boomer generation are reaching retirement age, seniors are becoming an increasingly important share of the population. Old age homes have been re-envisioned as retirement communities and again as activity living communities. As more people live past retirement age, it is increasingly important to better understand what improves not only the life expectancy of seniors, but also what will improve that quality of life for these individuals. A large body of research supports the conclusion that one way to do this is not to disengage from the world but to continue to participate in activities and social interaction.

Further Insights

Aging Theory

There are two dominant social theories on aging. Disengagement theory posits that society and the individual mutually sever many relationships during the aging process. According to this theory, it is important for older individuals to disengage from society. This both helps them to focus on their mortality and also increases the satisfaction these individuals have with their lives as well as enabling them to concentrate on issues related to aging and death. Since its introduction in 1961, disengagement theory has been widely criticized for many reasons, not the least of which is that it does not adequately or accurately describe the situation of many aging individuals and ignores much of the evidence about aging. Partially in response to the functionalist approach exemplified by disengagement theory, symbolic interactionists developed activity theory, which, although it, too, has its limitations, better accounts for much of the evidence on aging.

Symbolic interactionism is a sociological framework that assumes that one's self-concept is created through the interpretation of the symbolic gestures, words, actions, and appearances of others as observed during social interactions. When applied to aging, symbolic interactionists posit that those elderly individuals who remain active will be the most well-adjusted. Both anecdotal and research evidence support this theory. For example, in 1995 there was an intense heat wave in Chicago in which there was a heat index of 115 degrees Fahrenheit for two consecutive days. During this time, 733 individuals died from heat-related causes. Of these victims, approximately 75 percent were sixty-five years of age and older (Schaefer, 2002, p. 275-6). When analyzing the statistics to determine why this happened, researchers found that those with the highest risk of dying in that situation were older adults who lived alone. The analysis further found that within this category, older Hispanic and Asian Americans (both of whom typically have strong social networks with more regular contact with friends and family members) had a lower risk for death than other racial and ethnic groups. The conclusion was that support networks for older adults literally help save lives.

Activity Theory

Proponents of activity theory maintain that although older adults may not necessarily want to (or can) engage in the same activities as they did when they were younger (e.g., being employed, raising a family), they still have the same needs as other people for social interaction. In addition, as health care and medical science continue to improve the health of many older people and lengthen life expectancy, the need for social interaction increases. In addition, medical research is increasingly supporting the conclusion that social interaction and the maintenance of relationships and activities into later life is correlated with a lower decline in cognitive facilities than in people who do not have such activities and interests. As opposed to the disengagement theory of the structural functionalists, activity theory posits that withdrawal from society is bad for the individual who is reduced in status, isolated from society, and stripped of his/her role set as well as for a society itself, which loses the wisdom and insights that can only be gained by the accumulation of years of experience.

Activity theorists suggest that there are a number of different categories of activities that can enhance the quality of life for aging individuals. These include informal activities (social interaction with family and friends), formal activities (participation in group functions), and solitary activities (reading, watching television, and other pastimes). A number of empirical studies have found that older individuals who are active using the above criteria tend to be happier, have higher self-esteem, and a better quality of life. Activity theory has replaced disengagement theory as the dominant social theory of aging and has been the foundation for a number of successful aging programs. For example, activity theory has informed the philosophy of many nursing homes that have developed programs to increase the activities and social interactions of their residents as a way of improving their quality of life. This approach is thought by its proponents not only to be useful in improving the self-esteem and quality of life of older individuals, but also as a way to maximize their functional capabilities and help in rehabilitation efforts related to psychological and physical disabilities.

Applications

The Power of Positive Relationships

Social interaction is one of the primary considerations in activity theory. However, it is far from clear what types of social interaction improve an aging individual's quality of life or even what type of person is best helped by increased levels of social interaction. As discussed above, the positive relationship of social interaction — in particular positive relationships with family, friends, and community — is widely accepted. However, not every social interaction is positive. An increasing body of research suggests that both positive and negative support can be available (often from the same individual) at the same time and that these can positively and negatively affect one's well-being. Toni C. Antonucci, J. E. Lansford, and H. Akiyama (2001) researched the impact of positive and negative aspects of marital relationship and friendships on the well-being of older adults. Subjects in their study were a regionally representative sample of 1,702 individuals in the Detroit metropolitan area. Adults who were aged sixty and older, married, and had a best friend of the same gender were used in the study. Data were collected between 1992 and 1994 in face-to-face interviews. The response rate was 72 percent. Data collected included several demographic variables, depressive symptoms (as measured by the Center for Epidemiologic Studies depression scale), and a global measure of life satisfaction. Subjects were also asked to assess whether they confided in their spouse and best friend and whether these people got on their nerves. The data were analyzed using a series of multiple regression analyses.

The findings were consistent with previous research studies indicating the importance of both positive and negative social support in affecting well-being. In particular, the results indicated that women without a same-gender best friend were more likely to be depressed than men in the same situation. However, women with a same-gender confidant had lower levels of depression, similar to the level reported by men. Depression in men, on the other hand, was not found to be related to whether they had a same-gender confidant. Women without a best friend were found to be less satisfied with their lives than women with a best friend and than men in general. Having a best friend who got "on their nerves" was found to negatively impact the life satisfaction of men but positively impact the well-being of women. However, the study found that positive and negative relationships with one's spouse were related to depression and life satisfaction in the same ways for women and men. Having a spouse was found to be critical to the well-being of the subjects. Based on the findings, the researchers concluded that it is important to recognize that not all social interactions even in close social relationships are positive. Older persons need to develop alternative relationships in such a situation or reduce those interactions that are detrimental to their well-being. In addition, the findings support the observation that the loss of one's spouse can be devastating to one's well-being and mental health. Older people need to continue or develop other positive relationships as additional sources of well-being (Antonucci, Lansford, & Akiyama, 2001).

Social Support & Physical Recovery

Although a great deal of emphasis has been placed on the relationship between social interaction and emotional health in older adults, research has also shown that there is a positive relationship between social interaction and physical health as well. Depression is commonly found in coronary artery disease patients. Research has found that depression in this population is predictive of rehospitalization and increased disability. Depression occurring during hospitalization after a heart attack is also related to both short- and long-term survival. In the general population, one of the factors contributing to depression in these patients is lack of social support. H. B. Bosworth [M1]and[M2] colleagues (2000) performed research to determine whether social support would reduce the experience of negative events related to depression in coronary artery disease patients. Subjects in the study comprised a sample of 355 patients from a population of 2,319 patients hospitalized at Duke University Medical School with coronary artery disease. Subjects included in the study were those patients who were available in their rooms and able to complete a bedside diagnostic interview. Of this group, those patients who also had dementia, Parkinson's disease, multiple sclerosis, seizure disorder, untreated hyper- or hypothyroidism, or a history of stroke, brain injury, or alcohol dependence or abuse were eliminated from the study.

All subjects in the study were administered the Duke Depression Evaluation Schedule, a diagnostic interview instrument conducted by a trained mental health professional. The instrument includes questions to aid in the diagnosis of depression and other mental disorders as well as self-reported items that assessed physical functioning and abilities of daily living (e.g., ability to eat, dress, touch the floor) and instrumental activities of daily living (e.g., preparing meals, cleaning the house, shopping for necessities, taking care of routine financial matters). Other items collected data regarding perceived social support and interpersonal functioning. Multivariate statistical analysis was used to develop a model of predictors for depression in the sample. The results of the analyses suggested that those patients who were more prone to depression were typically non-white, had problems with at least one activity of daily living, had relatively fewer social interactions, and reported less social support than other subjects in the study. The findings further suggested that coronary artery disease patients with poor social interactions were more likely to be depressed following hospital admission. The researchers concluded that finding social support for these individuals or mobilizing their additional social support networks could decrease their chances for depression and concomitantly improve their recovery and survival. The researchers caution, however, that there are other possible explanations for the results. Further research is needed to better understand the interaction between social support and physical recovery.

Viewpoints

Virtually no theory is without its flaws, however, and activity theory is no exception. One of the criticisms leveled at activity theory is that the concomitant research is often too narrow in focus for wider extrapolation. For example, studies that examine the effects of activity on nursing-home residents tended to give scant attention to what types of activities are best used to improve self-esteem and quality of life, whether there is an interaction between activity type and desired outcome, and whether the utility of activity type changes with the personality of the individual. Further, much of the research on activity theory focuses on the outcomes (e.g., increased self-esteem or life satisfaction) but gives little or no attention to understanding the underlying processes that cause an activity to be successful. Another criticism of activity theory is that it is overly optimistic about the ability of activities to positively affect the quality of life for seniors. Many proponents of activity theory assume that any activity is better than no activity. Yet, research does not necessarily support this assumption. Observations of some practitioners have led to the conclusion that some activities may produce no change in the lives of seniors living in nursing homes or even be harmful to their psychological well-being.

Despite its empirical basis and relatively widespread implementation, activity theory still needs further investigation before it can adequately and accurately describe the real-world situation as experienced by all seniors. For example, in nursing homes, it has been observed that being active and being actively engaged are not necessarily the same thing. In addition, it has been posited by some observers that the aspects of activity in nursing homes that are the most engaging and helpful to the participants are the planning, preparation, and conduct of the activity. However, these social and cognitive aspects of nursing home activities are often performed by staff rather than residents, thereby reducing many of the potential good effects of the activities. Further, some theorists posit that the advantages of many activities derive from the social interactions that they enable. Although many nursing homes endorse the use of activity, some activities do not result in increased social interaction. Some theorists also point to the correlation between activity level and social interaction. However, correlation does not show causation. For many of these studies it is impossible to tell whether nursing home residents who are more socially active are more likely to participate in activities or if participation in activities makes one more socially active.

The interaction between activity, social engagement, and the health, well-being, and quality of life of seniors is a complex one and still not well understood. As discussed above, more research is needed to determine the underlying principles behind activity theory, what makes an activity of value for helping seniors, and what types of problems and personality types are best helped through participation in activities. That said, activity theory does show promise for practical application in improving the quality of life for seniors.

Conclusion

Activity theory posits that older adults who engage in activities and social interaction are more likely to be well adjusted than their peers. This not only can affect the psychological health of older individuals, but their physical health as well. Activity theory has been supported both by anecdotal evidence and research and has been widely used to inform the development of programs in nursing homes and other residency facilities for older adults. However, activity theory is not without its shortcomings. Additional research is necessary to better understand the underlying processes causing the positive effects of social interaction and activity in older adults as well as defining the parameters (e.g., gender, personality type, physical condition, type of activity or interaction) within which these findings apply.

Terms & Concepts

Activity Theory: A symbolic interactionist perspective on aging that posits that those elderly individuals who remain active will be the most well adjusted.

Baby Boomer: An individual who was born during an unusual period of greatly increased birth rate following World War II. Although there is no universally accepted span of years that comprise the baby boom, it is usually is considered to encompass people born during the years between 1946 and the early 1960s. However, the definition of both the start and end dates for the time period does vary slightly from researcher to researcher.

Bridge Job: A job taken by a person after leaving a job after the end of a career (particularly one that has a mandatory retirement age) but before the person is ready to really retire from work completely.

Correlation: The degree to which two events or variables are consistently related. Correlation may be positive (i.e., as the value of one variable increases the value of the other variable increases), negative (i.e., as the value of one variable increases the value of the other variable decreases), or zero (i.e., the values of the two variables are unrelated). Correlation does not imply causation.

Disengagement Theory: A functionalist theory of aging that posits that society and the individual mutually sever many relationships during the aging process.

Empirical: Theories or evidence that are derived from or based on observation or experiment.

Functionalism: A theoretical framework used in sociology that attempts to explain the nature of social order and the relationship between the various parts (structures) in society and their contribution to the stability of the society by examining the functionality of each to determine how it contributes to the stability of society as a whole. Also referred to as structural functionalism.

Quality of Life: The sense of well-being that an individual feels regarding his/her life circumstances and lifestyle; the ability to enjoy one's normal life activities. As opposed to standard of living, quality of life is both intangible and subjective.

Multivariate Statistics: A branch of statistics that is used to summarize, represent, and analyze multiple quantitative measurements obtained on a number of individuals or objects. Examples of multivariate statistics include factor analysis, cluster analysis, and multivariate analysis of variance (MANOVA).

Regression Analysis: A family of statistical techniques used to develop a mathematical model for use in predicting one variable from the knowledge of another variable.

Social Interaction: The changing series of social actions between individuals or groups that modify their reactions based on the actions of the other party. Social interactions are events to which the participants attach meaning. Social interaction may be planned or accidental, regular or occasional.

Society: A distinct group of people who live within the same territory, share a common culture and way of life, and are relatively independent from people outside the group. Society includes systems of social interactions that govern both culture and social organization.

Status: A socially established position within a society or other social structure that carries with it a recognized level of prestige.

Subject: A participant in a research study or experiment whose responses are observed, recorded, and analyzed.

Symbolic Interactionism: A theory that assumes that one's self-concept is created through the interpretation of the symbolic gestures, words, actions, and appearances of others as observed during social interactions.

Bibliography

Antonucci, T. C., Lansford, J. E., & Akiyama, H. (2001). Impact of positive and negative aspects of marital relationships and friendships on well-being of older adults. Applied Developmental Science, 5 , 68-75. Retrieved June 30, 2008 from EBSCO Online Database SocINDEX with Full Text http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=4758243&site=ehost-live

Bosworth, H. B., Steffens, D. C., Kuchibhatla, M. N., Jiang, W. J., Arias, R. M., O'Connor, C. M., & Krishnan, K. R. R. (2000). The relationship of social support, social networks and negative events with depression in patients with coronary artery disease. Aging and Mental Health, 4 , 253-258. Retrieved June 30, 2008 from EBSCO Online Database SocINDEX with Full Text http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=3958600&site=ehost-live

Hrast, M. F., Hlebec, V., & Kavcic, M. (2012). The social exclusion of the elderly: a mixed-methods study in Slovenia. Czech Sociological Review, 48, 1051–1074. Retrieved November 1, 2013 from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=85679582

Kurian, R., & Uchiyama, C. (2012). Models of elderly care in Japan and the Netherlands: social quality perspectives. International Journal of Social Quality, 2, 74–88. Retrieved November 1, 2013 from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=83182940

Pittaoulis, M. (2004). Nursing home activities: An exploration of the limitations of activity theory. Conference Papers- American Sociological Association 2004 Meeting, San Francisco, 1-19. Retrieved June 30, 2008 from EBSCO Online Database SocINDEX with Full Text http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=15930730&site=ehost-live

Schaefer, R. T. (2002). Sociology: A brief introduction (4th ed.). Boston: McGraw-Hill.

Shen, S., Li, F., & Tanui, J. (2012). Quality of life and old age social welfare system for the rural elderly in China. Ageing International, 37, 285–299. Retrieved November 1, 2013 from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=78304258

Suggested Reading

Damiaakis, T., Wagner, L. M., Berstein, S., & Marziali, E. (2007). Volunteers' experiences visiting the cognitively impaired in nursing homes: A friendly visiting program. Canadian Journal on Aging, 26 , 343-356. Retrieved June 30, 2008 from EBSCO Online Database SocINDEX with Full Text http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=30099289&site=ehost-live.

Dorfman, L. T., Lieckerl, D. A., Hili, E. A., & Kohous, F. I. (1988). Retirement satisfaction in rural husbands and wives. Rural Sociology, 53 , 25-39. Retrieved June 30, 2008 from EBSCO Online Database SocINDEX with Full Text http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=13080081&site=ehost-live.

Hinterlong, J. E. & Williamson, A. (2006). The effects of civic engagement of current and future cohorts of older adults. Generations, 30 , 10-17. Retrieved June 30, 2008 from EBSCO Online Database SocINDEX with Full Text http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=25027659&site=ehost-live

Joubert, L., Lee, J., McKeever, U., & Holland, L. (2013). Caring for depressed elderly in the emergency department: establishing links between sub-acute, primary, and community care. Social Work in Health Care, 52(2/3), 222–238. Retrieved November 1, 2013 from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=86277642

Mutran, E. & Reitzes, D. C. (1984). Intergenerational support activities and well-being among the elderly: A convergence of exchange and symbolic interaction perspectives. American Sociological Review, 49 , 117-130. Retrieved June 30, 2008 from EBSCO Online Database SocINDEX with Full Text http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=14753746&site=ehost-live.

Segrist, K. (2005). Assessing impact of service-learning project on older, isolated adults in rural America. Journal of Intergenerational relationships, 3 , 101-115. Retrieved June 30, 2008 from EBSCO Online Database SocINDEX with Full Text http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=27650718&site=ehost-live. [M1] [M2]