Chapter 5

Summary and Conclusion

5.1 Summary
In summary, while indicating important dimensions of inequality, this brief description of

the position of older ethnic minority people indicates that the situation is a little more complex

than is suggested by claims that older ethnic minority people simply face multiple sources of

disadvantage. The quantitative part of the study revealed extensive differences across ethnic

groups in most of the established influences on QoL that were covered in the data. Factors that

are typically included in research concerned with inequality (material conditions, health, crime

and physical environment and formal assessments of social participation) revealed a familiar

pattern. The white group tended to have the best scores. However, for those influences concerned

with less formal elements of the community, social support and perceptions of the quality of

local amenities, the differences were reversed.

As has already been mentioned, the circumstances and hence the QoL in old age cannot be

separated from the experience of ageing. The concept of the lifecourse has become increasingly

popular area of research in both social gerontology (Dannefer 2003) and health sciences (Blane

et al. 1997; Kuh and Ben-Shlomo 1997; Blane, 1999; Graham, 2002). Epidemiological studies

have demonstrated lifecourse influences on both physical (Montgomery et al. 2000) and mental

health (Power et al. 2002) in later [Link], little work has been done to look at the

lifecourse influences on QoL in early old age. The fourth and final study concerned with

inequalities in QoL in older age combined a range of lifecourse and contemporary data about

people’s circumstances with a novel measure of QoL.

1
 A new measure of QoL was developed in response to the widely acknowledged lack of

theory in the area. Many existing scales are not explicit about the theoretical model and, thus, the

concept that was being measured (Gill and Feinstein 1994). The main problems were, either that

proxy measures such as health, financial status or social networks were used to measure QoL, or

that QoL was regarded as a completely subjective phenomenon. The measure of QoL was based

on the theory of needs satisfaction. The items were tested with focus groups, cognitive interviews

and by statistical analyses. These produced a 19-item scale labelled the CASP-19 (Higgs et al.

2003; Hyde et al 2003).

5.2 Conclusions

By studying the perceptions of the oldest old about their informal social relationships,

this study aimed at finding out, what kind of restrictions to social relationships do Old Age

people experience, how are social relationships significant for Old Age people and what aspects

of social relationships are valued by Old Age people. Hence, the study aimed at deepening the

understanding of social relationships in very old age. An extensive summary of the findings and

discussion of the results is provided in the previous chapter. This chapter provides a condensed

overview of the findings along with some strengths, limitations and ethical considerations of the

study. Furthermore, a call for further studies is indicated.

The findings of this study indicate that, in multiple ways, social relationships are

significant in the lives of Old Age people. Old Age people receive help, company and feelings of

joy from their informal social relationships, but also unpleasant feelings, although not very often

described, are present. In addition, not only current social relationships proved to be significant,

but also influential social relationships one has had in the past, such as one’s own parents.

2
Clearly, the Old Age people in this study valued having social relationships, especially

harmonious ones, and they found loneliness and being alone undesirable. At the same time, Old

Age people encountered various circumstances in their lives, which restricted their social

relationships. These restrictions were also mostly outside the influence of the Old Age people

themselves. Thus, it seems that there might be a contradiction between the aspirations of the

oldest old regarding their social relationships and their possibilities to fulfil those aspirations.

The limitations of the study are related to possible overrepresentation of healthier and more

active Old Age people as participants of this study compared to the most vulnerable in terms of

health, mental abilities and other resources. In addition, all the participants in this study were

living in their own home or in sheltered housing and no Old Age people living in institutions

were participating. Furthermore, limitations related to the data collection method and data

analysis can be recognized. These include the possible effects of the interviewers to the interview

process and the possible influence of the researcher’s presuppositions in the analysis and

interpretation of the data.

However, the effects of these limitations were minimized by careful and systematic

procedures followed in every phase of the study. Strengths of the study are also evident, since the

use of extensive interview data has enabled in-depth and varied descriptions of the studied

subject and, therefore, the considerations of multiple perspectives leading to the recognition of

various different aspects of informal social relationships in very old age. Limitations and

strengths of the study are discussed more broadly in the chapter 4.4.

The author of this study is obliged by a written contract to follow the guidelines of The Finnish

Advisory Board on Research Integrity (2012) for responsible conduct of research. Furthermore,

as also the contract obliges, the author has handled the data carefully and confidentially and used

3
it only for the purpose of this thesis. After the completion of the thesis, the data will be

destroyed. As original quotations of the study participants are used in the results section of this

thesis to validate the analysis of the data, careful attention has been paid on the anonymity of the

study subjects. The collection of the data used in this thesis was approved by the Ethical

Committee of local hospital district.

The findings of this study give reason for further research on the topic. As a contradiction

between both the significance and appreciation of social relationships and the possibilities of

older individuals to influence the realization of their social engagement was found, more

attention is needed to recognize the manifold obstacles the oldest old encounter, and to find

solutions to alleviate the negative effects of those obstacles for their social lives. As telephone

was found to be an important means to stay socially connected, the possibilities of technology in

facilitating and enabling social connectedness of the oldest old should be investigated further.

According to my findings, family plays a central role in the lives of Old Age people and family

is also an important source of help for Old Age people, especially children as providers of help.

By helping to manage everyday chores the informal social relationships also contribute to the

independence of the older persons, allowing them to keep living in their own home. Therefore, it

seems, that those older persons with children and grandchildren are in a better position, with

regard to social engagement and receiving help, than those with no children or those whose

children are living far away.

Furthermore, this study was not able to take into consideration the perceptions of those

oldest old persons living in institutions. Whether they have similar or somehow different

perceptions about social relationships, should be resolved by further qualitative studies.

Consequently, different family compositions, life circumstances, and resources of the oldest old

4
should be considered in further studies, in order to gain even more detailed knowledge about the

oldest old and to ensure that the perceptions of also those who are in less advantaged positions

are taken into consideration.

This study has revealed some aspects of the informal social relationships of the oldest old

individuals and has, therefore, contributed to the enhancement of the understanding of the oldest

old persons’ perceptions regarding informal social relationships. Furthermore, by studying the

perceptions of the oldest old themselves about their social relationships, this study has been able

to take into account the diversity and complexity of experiences, also highlighting, that the oldest

old are not a homogeneous group. In order to better understand very old age in its multiformity,

various, and also divergent, perceptions need to be acknowledged. Consequently, more studies

using qualitative approach are needed to capture the multiple aspects of (social) life in the oldest

old age.