Loneliness and Anxiety About Aging in Adult Day Care Centers and Continuing Care Retirement Communities

Abstract

Background and objectives: The present study compares how 2 settings: adult day care centers (ADCCs) and continuing care retirement communities (CCRCs) fare with regard to loneliness and anxiety about aging. Loneliness is a highly prevalent and distressing subjective experience of inadequate social relations, which has negative effects on health and well-being. Anxiety about aging is defined as worries brought up by imagining the negative consequences and losses associated with old age. The study also examines whether anxiety about aging accounts for differences in loneliness between the 2 settings. This study took place in Israel, where ADCCs are funded by the National Insurance Institute of Israel and CCRCs tend to be funded by private income and wealth. Despite notable differences between the settings, a common goal of both is to reduce loneliness among older adults.

Research design and methods: A cross-sectional design of 4 ADCCs and 4 CCRCs (N = 456).

Results: Compared with CCRC residents, older adults in ADCCs reported higher levels of loneliness (Mean [SD] = 1.46 [0.60], Mean [SD] = 1.78 [0.80], respectively, t [df]= -5.10 [448], p < .001) and higher levels of anxiety about aging (Mean [SD] = 2.96 [0.88], Mean [SD] = 3.27 [0.99], respectively, t [df] = -3.42 [440], p < .001). Anxiety about aging partially accounted for the differences between the 2 settings in levels of loneliness (B = 0.03, 95% confidence interval [CI]: 0.0037-0.0651).

Discussion and implications: Although it is not possible to determine causality from this cross-sectional design, it is possible that CCRCs provide a better social outlet for older adults than ADCCs.

Keywords: Ageism; Frailty; Isolation; Long-term care; Social support.