Journal of Gerontological Nursing

RETIREMENT: Aspects, Response, and Nursing Implications RETIREMENT: Aspects, Response, and Nursing Implications

Carolyn S Cassels, RN, MSN; Anna M Eckstein, RN, MSN; Katherine M Fortinash, RN, MSN

Abstract

This kind of course or workshop can encourage the prereti ree to analyze value systems, and select things that are important, from a number of alternative choices. Such introspection can motivate the preretiree to think about retirement in a positive, productive light, and perhaps formulate constructive goals based on personal values and beliefs.

Also, clarification of one's belief system prepares one to carefully weigh positive and negative consequences so that making a choice becomes a learning experience. A critique of one's values can also be useful in learning why one behaves a certain way, and can be a primary step toward changing negative patterns of behavior.

Role mastery helps the preretiree develop confidence and pride in work well done, which is necessary to complete successfully the transitional period from the working to the nonworking world. It also helps the preretiree gain recognition and approval for technical tasks and/or skills that will increase self-worth, self-image, and ability to function productively during retirement.

TABLE 1

PRERETIREMENT COURSE…

Shakespeare, when he divided man's life into seven ages, made no provision for retirement. The omission was not an oversight. Working men were not expected to retire at an appointed age in Shakespeare's day - nor for many decades thereafter. But this century. . .has brought revolutionary changes in the concept of the work ethic. And these changes have led in a step-by step process, to the addition of an eighth age to the life of man - the age of retirement.1

Introduction

Retirement is considered a major transition in an individual's life. We conducted a study to examine selected aspects of the retirement transition and to identify how the retiree might best be served by nursing intervention.

The objectives of the study were:

1. To identify, through the literature and by questionnaire, the retiree's response to five variables: socioeconomic status, health, family and friends, attitudes, and feelings and activities.

2. To demonstrate the needs of retired individuals at various socioeconomic levels.

3. To list recommendations for nursing that promote the successful retirement and good health of the individual

Literature Review

Socioeconomic Status

Streib and Schneider2 reported that because people of variable socioeconomic classes have different accesses to society's resources, the stratification system is of particular relevance to aging and retirement, a time when resources generally become scarce. A 1978 congressional report by the General Accounting Office of the federal government suggested that health is a prominent factor in determining the worker's decision to retire, but the need to maintain an income remains imperative. This report also revealed that people of high socioeconomic status (those with a combination of more years of education, higher income, and white-collar vocations) tended to have lower retirement rates, and may experience more difficulty in adjusting to retirement.

The literature concludes that retirees whose health and economic situations are poor, and those whose previously productive roles are greatly diminished, usually adjust successfully to retirement.

Health

A decline in reported health does not seem to be the result of retirement. People who continue to work show about the same kind of decline in self-assessment of their health as do those who retire.2

Ellison4 argued that "the social context of retirement. . .is a precipitating factor in the illness of people after retirement", and suggested that illness may be brought about if : (a) the loss of the economic, social and psychological functions of the work role produces in the retiree a "giving up to" or a "lack of fit in" the retired role; and/or (b) significant others view retirement as having a fatal prognosis and expect the retired person to adopt a dependent "sick role." Ellison contended that illness may be an alternative to or legitimate escape from idleness, particularly for the blue-collar worker who views retirement as undesirable.

Family and Friends

Ellison4 suggested that the outcome of retirement depends to a considerable extent on the attitudes of both the retiree and his/her significant others.

A confidant - one with whom a person can have a close, intimate relationship - can lessen the impact of stressful situations. Lowenthal and Haven5 found that the maintenance of a stable, intimate relationship was associated closely with good mental health and high morale.

Attitudes and Feelings

Stevenson suggested that higherpaid persons may have more interesting jobs, thus greater commitments to their work. Not only do these persons continue to live according to a pace and trajectory they set in earlier years, but they may also enjoy better health for a longer time than those of lower socioeconomic status. Retirement has been equated with old age. Walker and Lazur7 suggest that, for some people, postponing retirement means avoiding old age. This view may be the result of an overly negative stereotype of old age in American society. However, given the trends of increasing longevity, better health and earlier retirement, this negative perception may be changing.

Activities

Authors agree that involvement in activity and how leisure time is spent are very important considerations for the retired person. Researchers have found that preretirement activities frequently carry over into postretirement years, when the retiree has more time to devote to personal interest.

Peppers,8 in his study of leisure activity and adjustment to retirement, revealed that the five most popular activities were: visiting friends, watching television, performing odd jobs at home, traveling and touring, and reading. A total of 57 different activities was listed, and the number enjoyed after retirement rose significantly. Interestingly, eight of the top 10 activities were of the isolated type. An unexpected finding was that these isolated activities were equally as popular with the same respondents prior to retirement, which would suggest that interest in such activities was not a function of retirement itself, but more a pattern of living within our society.

Methods

Study Subjects

The study subjects were male and female white Americans between the ages of 64 and 75 years. To control for the influence of foreign sociocultural backgrounds, the subjects must have lived in the U.S.A. for a period of at least 20 years.

The marital status of subjects were: (a) presently married and living with spouse; (b) never married and living alone or with others; and (c) widowed or divorced for a period of at least two years and living alone or with others. It was felt that the two-year period would allow the retiree adequate time for the normal grieving process to run its course; therefore, overt grief would not be a major influence on the subjects' responses.

The participants were in reasonably good health, as defined by freedom from long-term illnesses and ability to perform the necessary functions of self-care. Subjects had retired voluntarily or mandatorily and had been retired for at least two years.

Questionnaire

A total of 36 sample questions was drawn from the following three sources:

1. Wave 2 and Wave 5 of the Cornell Study of Occupational Retirement, 1952 to 1959.2 Questions relevant to all five variables were derived from this comprehensive 8-year longitudinal study of 1,969 preretired and retired persons. Questions about retirement counseling also were selected to evaluate retrospectively educational/informational needs of retirees.

2. Cornell Medical Center, Study of the Social and Emotional Needs of Chronically 111 Elderly Patients Over 60 Attending a General Medical Clinic, 1958.9 Questions relevant to activities and immediate living arrangements were selected from this pretested interview study of 200 persons of retirement age.

3. Hollingshead Two Factor Index of Social Position, 1958. Questions regarding completed education and occupation were derived from this scale.

Sampling Procedure

Cluster samples were drawn from three communities within southern California. The study sample of 92 respondents consisted of 47 women and 45 men, mean age 69. 1 years. At the time of the study, 20 women and 29 men were married; 24 women and 13 men were widowed, separated or divorced; and 3 women and 5 men were never married. Of the 92 respondents, 27 (29%) had been retired 2 to 5 years, 34 (37%) had been retired 5 to 10 years, and 3 1(34%) had been retired 10 years or more.

In accordance with job descriptions and levels of education, respondents were matched to the appropriate classification in the Hollingshead Occupational and Educational Scale.

The Hollingshead Two Factor Index of Social Position is based upon the assumptions that: (a) certain occupations are more highly valued in society than others; and (b) persons having comparable education are likely to share comparable tastes, attitudes, and patterns of behavior. The total sample was divided into three socioeconomic groups.

The Upper Socioeconomic Group consisted of 21 subjects: 10 women and 1 1 men. In this group there were 11 "major" professionals and 10 "lesser" professionals.

The Middle Socioeconomic Group consisted of 57 subjects: 31 women and 26 men. In this group there were 22 "minor" professionals 25 clerical/technical workers, and 10 skilled manual workers.

The Lower Socioeconomic Group consisted of 14 subjects: 6 women and 8 men. In this group there were 9 semi-skilled workers and 5 unskilled workers.

Results

Socioeconomic Status

A consistent finding in both the literature review and the study was that most retirees felt "a change in income was a change for the worse" since retirement.

There were significant differences in the standard of living among the upper, middle, and lower socioeconomic classes, because of the varied sources of income between classes. The upper and part of the middle socioeconomic population could retain financial stability because of financial investments, whereas the lower socioeconomic group depended primarily on social security and/or pensions for income.

People in all three groups expressed concern for their ability to adjust to a rapidly increasing cost of living. Statements like, "I worry about money" and "I have enough for now but worry about inflation," were reported frequently.

The investigators were impressed with the resiliency of the entire sample in their ability to adjust expenses to their available income.

Health

Consistent with the literature, retirement was not found to have a significant impact on the health of the majority of the sample. In fact, nearly one- fourth of the total sample reported improved health since retirement.

Another consistent finding was that the lower socioeconomic group exhibited more overt signs of physical illness and debilitation, such as those provided by chronic alcoholism, than either of the other two groups.

The upper and middle socioeconomic groups subjectively rated their health as "generally better" than the lower socioeconomic group. However, individual statements of "fear of future failing health", were expressed by some respondents.

Family and Friends

Several findings about family and friends agreed with the literature. The upper socioeconomic couples reflected a very positive retirement experience (the highest number of married persons was in this group). Many respondents remarked that their spouse was their "best friend" and/or "advisor." The evaluation of family as a "close family group" was highest among these subjects. Only one person reported the abscence of any close friends with whom he/she could discuss personal matters.

Among the middle socioeconomic group the retirement response was good, but not quite the same as the upper level response. The evaluation of family as "close" and the number of close friends dropped slightly. Problems with "just being at home" or "having my husband at home all the time" appeared in this group.

The number of currently married couples in the lower socioeconomic group was very low (three out of 14). This group represented the highest percentage of widowed, divorced, or never married subjects. The absence of any close friends or confidants was higher in this group than in the middle or upper socioeconomic groups.

These particular findings among groups support previous studies that cite the importance of the support of significant others in successful retirement adjustment.

Attitudes

The majority of people in all three socioeconomic groups agreed that "retirement is good for a reason," "not working has not been difficult," and they did "not want to go back to work." These findings would suggest that the commitment to the work role as a primary source of satisfaction in life has declined.

However, other important differences among groups were noted. Although all three groups indicated a general improvement in their "outlook on life," a higher percentage of people in the lower socioeconomic class fell that their "outlook on life" had improved since leaving their jobs. Because this population included a number of factory workers and hard laborers, their improved outlook may be due to a "sense of relief" from a lifetime of burdensome work.

the normal grieving process to run its course; therefore, overt grief would not be a major influence on the subjects' responses.

The participants were in reasonably good health, as defined by freedom from long-term illnesses and ability to perform the necessary functions of self-care. Subjects had retired voluntarily or mandatorily and had been retired for at least two years.

Higher income and better selfrated health were found to be the predominant influences on the successful retirement of the upper socioeconomic group.

Overall, the majority of retirees thought of themselves as "middleaged," contradicting the prevailing attitude of society, which is to consider them "old."

Activities

While we did not make a pre- and post-retirement comparison of activity types, we did find that "alone" or "isolate" activities were pursued more frequently and were noted on the upper half of the list, while the "group" or "social" activities were pursued less frequently and ranked in the lower half.

So few people stated that they "often" sat alone and did nothing that it can be concluded that activity of some type, either aloneor socially, is considered more desirable by most of the participants. The need to study other activities for retirees in order to anticipate their needs and to help make retirement years more fulfilling is evident.

Implications for Nursing Practice

Retirement Education

Self-awareness of one's values is an important factor in the identity of one's role at any age, but it appears to be even more crucial during the retirement years, when one's integrity and self-worth are threatened. Another major determinant for successful identity formation is role mastery, or skill development. The creative use of one's talents and the joy of achievement can earn the retired citizen the recognition, acceptance, and approval needed to make the transition successfully from one role to another.

In a brief course designed for preretired individuals, the nurse can counsel the retiree in establishing new roles that fit the retirees' unique goals and lifestyles, as well as financial status. This course, based on teaching methods derived from the textbook Values Clarification, by Simon, Howe, and Kirschenbaum," is designed to help the preretiree develop an awareness of his or her own personal value system, and to develop a unique and personal role that can be mastered comfortably and successfully. The objectives of such a course are listed in Table 1.

Table

TABLE 1PRERETIREMENT COURSE

TABLE 1

PRERETIREMENT COURSE

This kind of course or workshop can encourage the prereti ree to analyze value systems, and select things that are important, from a number of alternative choices. Such introspection can motivate the preretiree to think about retirement in a positive, productive light, and perhaps formulate constructive goals based on personal values and beliefs.

Also, clarification of one's belief system prepares one to carefully weigh positive and negative consequences so that making a choice becomes a learning experience. A critique of one's values can also be useful in learning why one behaves a certain way, and can be a primary step toward changing negative patterns of behavior.

Role mastery helps the preretiree develop confidence and pride in work well done, which is necessary to complete successfully the transitional period from the working to the nonworking world. It also helps the preretiree gain recognition and approval for technical tasks and/or skills that will increase self-worth, self-image, and ability to function productively during retirement.

References

  • 1. O'Meara JR. Retirement: Reward or rejection. The Conference Board. Library of Congress Report No. 713. Washington, D.C., U.S. Government Printing Office, 1977.
  • 2. Streib GF, Schneider CJ. Retirement in American Society: Impact and Process. Ithaca, N. Y., Cornell University Press, 1971.
  • 3. General Accounting Office Survey: Government and Geriatrics. Retirement: When, why, how? Geriatrics 1978; 33:15-6.
  • 4. Ellison DL. Work, retirement, and the sick role. Gerontologist 1968; 8:189-92.
  • 5. Lowenthal MF, Haven C. Interaction and adaptation: Intimacy as a critical variable. Amer Sociol Rev 1968; 33:2051.
  • 6. Stevenson JS. Middlescene. New York, Appleton-Century-Crofts, 1977.
  • 7. Walker J, Lazur H. (eds). The End of Mandatory Retirement. New York, John Wiley & Sons, 1978.
  • 8. Peppers LG. Patterns of leisure and adjustment toretirement. Gerontologist 1976; 16:441-5.
  • 9. Schwartz D, Henley B. Zeitz L. The Elderly Ambulatory Patient: Nursing and Psychosocial Needs. New York, Macmillan, 1964.
  • 10. Miller D. Handbook of Research Design and Social Measurement. New York, David McKay, 1977.
  • 11. Simon SB, Howe LW, Kirschenbaum H. Values Clarification. New York, Hart, 1972.

TABLE 1

PRERETIREMENT COURSE

10.3928/0098-9134-19810601-07

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