Home Education Knowledge and Action
Exploration of Interindividual Variability Over Time in a Case Contrast Approach
In this section we again examine the key areas of out-of-home mobility from the above perspective and contrast selected extreme cases in their divergent trajectories. We use the total sample as a platform for overall comparison and provide background material and quotations, and figures to improve understanding of this diversity. In addition, Fig. 15.1 provides an illustration of interindividual differences in mobility as people age.
In comparison with changes in satisfaction of the total sample, the changes in satisfaction of Mr. Lechner (80 years old) and Mrs. Dahlmann (87 years old) mirror characteristic developments over the 10-year interval (Fig. 15.1, panel a). Mr. Lechner’s satisfaction with his out-of-home mobility options had decreased between the years 1995 (M = 10.0) and 2000 (M = 9.0) because of a severe illness. He recovered between the second and the third assessment and was happy about his new freedom: “Thanks to my recovery it is possible to put more strain on my body, and I make the most of it for trips, hiking, and long-distance trips.”
Together with his wife he walks at least five to six kilometers every day and does all his shopping and errands on foot or by public transport because they have no car available. He is still able to actively pursue his hobbies—cooking, painting, and forming wood and other materials—and because he experiences no impairments he said, “Hence, I can be quite satisfied” (M = 9.0).
The course that Mrs. Dahlmann’s satisfaction took was quite different. Her mobility-related satisfaction had increased between 1995 (M = 7.0) and 2000 (M = 9.00). However, she suffered from late effects of a cancer surgery and had to undergo operations on her veins and hip joint between the second and third assessment. Because the latter surgery was not completely successful, her mobility is severely restricted. She can still reach shops and services in the neighborhood on foot. However, longer trips are no longer possible: She gave up driving and is not yet accustomed to using public transport.
Inside activities are only a little limited—of course, my range is not large and that makes a big difference. But outdoor mobility and out-of-home activities are restricted....Actually, because of pain I walk with the aid of a cane anyway, and I feel extremely unsure as a result....The movability of my feet has decreased, and when I step down a curb or something similar I have to pay careful attention....In the past I loved hiking, even in high mountain areas—but this is no longer possible. My activities are limited to what I have to do: shopping and what is necessary for daily living.
Fig. 15.1 Case examples to illustrate inter-individual differences in intra-individual changes in mobility-related indicators and general life satisfaction (Note: Satisfaction was assessed on an 11-point scale ranging from 0 (not satisfied at all) to 10 (very satisfied). Design by authors)
Against this background, Mrs. Dahlmann’s satisfaction with her possibilities of moving about decreased sharply in the third measurement (M = 3.0). Together, the two examples point to large individual differences behind the general tendencies (Fig. 15.1).
The diverging individual conditions and experiences and the resulting evaluations regarding satisfaction with public transportation are again underscored with two examples (Fig. 15.1, panel b). Mrs. Faust, 77 years old, has taken daily care of her husband, who has been living in a nursing home. Her limited possibilities of moving about were reflected by a rather low satisfaction with public transport
(1995: M = 5.0). When her husband passed away between the second and third assessment, she was able to recover from this difficult life event mainly by pursuing out-of-home activities. Because she never obtained a driver’s license, she has taken most of her trips on foot or by public transport. Because of her severe visual impairment, she has difficulties orientating herself when moving about on foot. For several years now public transport modes have therefore grown in significance to her because they allow her to maintain her activities (2000: M = 8.0; 2005: M = 9.0). “Everything by bus or tram,” she said. “Except to the baker’s. I walk there because of my visual impairment and—well, indeed, you are no longer entirely agile with advancing age.”
Mr. Nolte is 88 years old and seriously impaired in his physical mobility. Nonetheless, in the first and second assessments he was still quite satisfied with public transport (1995: M = 9.0; 2000: M = 8.0). However, between the second and third assessment, his state of health worsened to the extent that he has depended ever since on help to be able to leave the house, so his satisfaction dropped to zero (M = 0.0). He complained:
My problem is that I no longer have the strength to walk to the tram stop by myself... because I am physically handicapped. I am no longer satisfied with the tram because I cannot use it anymore!
Satisfaction with one’s possibilities for travel decreased significantly over time even among nonimpaired elders, whereas satisfaction with leisure opportunities stayed almost the same in the respective intervals. There were again great individual differences, however, as seen in the examples of Mrs. Pfeil and Mrs. Weimann (Fig. 15.1, panels c and d).
The options for leisure activities and travel for 72-year-old Mrs. Pfeil had improved substantially in the last several years before the third assessment, not because of her health but because of changes in her social network. Caring for her almost 100-year-old mother required a great deal of time and energy and made other activities almost impossible. The situation changed when her mother passed away in 2002. “Since retiring., I often take short trips, short cultural trips. Longer travel was not possible as long as my mother was living. I always went to see her. This has improved a lot now.” Mrs. Pfeil was able to slowly resume her previous hobbies and traveling.
Well, I occupy myself with my computer, with my video recorder. I have been doing this for some time and have built up a little video Library. I read—there just isn’t time enough! I listen to music, actually everything beautiful....I watch TV, especially cultural programs.... Moreover, I visit the museum. In fact, outside the home I exercise, bowl, attend the theater and concerts, major events such as the one in the park recently.
Her wide range of activities contributes substantially to both her satisfaction with possibilities of pursuing outdoor leisure activities (2000: M = 6.0; 2005: M = 8.0) and travel (2000: M = 5.0; 2005: M = 7.0).
Mrs. Weimann, 85 years old, is experiencing quite the opposite. Her husband’s stroke has so severely restricted his mobility and reactions that she has to support him in almost all his activities of daily living. This situation heavily impacts her own and shared activities.
Leisure—I am rather satisfied in this regard....I still can go out with the dog; and at home, of course, I can do cooking, baking, gardening. Elsewhere, I play golf and bridge—but the latter is more in winter....What is hard is that I can no longer play golf with my husband, that we can no longer take bicycle tours together, and that we cannot go on holiday anymore....I cannot take him with me. Even if he had a wheelchair, he would not be able to move around.
Consequently, her satisfaction with leisure activities, which had the highest rating (M = 10) in 1995, fell to M = 8.0 in 2000 and to M =7.0 in 2005. Regarding satisfaction with travel, the decline was even worse (1995: M = 9.0; 2000: 0.0; 2005: 1.0).
With respect to individual differences in general life satisfaction (Fig. 15.1, panel e), we refer again to Mrs. Pfeil, whose satisfaction with outdoor activities and travel rose remarkably when she no longer needed to care for her mother, a task that had prevented her from pursuing desired activities. The same holds true for her satisfaction with life in general. Starting from a very low rating (M = 5.0) in the first assessment in 1995, her subjective quality of life also increased when her radius of action widened again (2000: M = 8.0; 2005: M = 10).
Well, as long as I worried about my mother—I mean, even though she was very old she was still my mother. You are so worried, it was like a cloud hovering over you. We watched her decline for four years, and we did a lot of grieving. Meanwhile, I have gotten over it and can say, “This has changed.” And this burden—it is a burden, whether you want to admit it or not—this has changed.
Hence, the positive changes in Mrs. Pfeil’s out-of-home options and her related domain-specific satisfaction and subjective quality of life are due to changes in her social commitments.
By comparison, the example of 86-year-old Mr. Walter represents those men and women whose satisfaction with life in general decreased with advancing age, particularly because of health and mobility impairments. Although Mr. Walter was completely satisfied with his life in the first assessment (M = 10) and almost equally satisfied 5 years later (M = 9.0), this appraisal decreased in the third assessment (M = 7.0), although he did not suffer from severe impairments. Instead, he reported a general decline that most aging people have to cope with: “Because movability has diminished and sensitivity to pain has increased—thus we are somewhat less satisfied, I would say.”
At the same time he is an example of the strength and adaptability older people develop in order to meet everyday hardships and to maintain satisfying activities despite mobility restrictions. “But yes, we struggle through, there is no whining and sniveling.... When the weather is reasonable we sit outside in the garden, and mostly we are four to five more people; that’s fun.”
|< Prev||CONTENTS||Next >|