Satisfaction in Older Adults by Keith Torkelson MS, BS

 

Contents

• Requirements/Specifications
• Measurement – Related to Satisfaction of Older Adults
• FYI - Apply CEGU Probation to OAs
• Resistance to Dying Old Man Syndrome (DOM-S) – 15 Items
• NIH Older Adult Satisfaction – 12 Items (Derived)
• Life Satisfaction Theory & 4 Contributing Factors (+ Scale) I
• Years from Death
• Life Satisfaction Theory & 4 Contributing Factors (+ Scale) II
• Feature Images
• The Homeless Older Adult – Veteran
• NIH on Older Adults - Satisfaction
• “satisfaction survey for older adults”
• Older People’s Usage Pattern, Satisfaction with Community Facility and Well-Being in Urban Old Districts
• Longevity - Where you go - What you do
• Multiple factors associated with life satisfaction in older adults
• Person of Interest – Claudia Kawas, MD

Measurement – Related to Satisfaction of Older Adults

>We derived 3 assessments for this study: NIH Older Adult Satisfaction – 12 Items (Older Adult Satisfaction), Resistance to Dying Old Man Syndrome (DOM-S) – 15 Items & Senior Center Repurposed to MHSA Wellness Center West (WCW) Satisfaction Assessment.  Our Resistance to Dying score for 20250710-TH-RT-JB is 86.7% where High Scores are Favorable. By inverting the Resistance score we get our Progress Towards Dying score for 20250710 of 13.3% where Low Scores are Favorable.  Our NIH Older adults’ Satisfaction Score for 20250710-TH-RT is 90.0% where High Scores are Favorable.  Overall we are satisfied with the Wellness Center West.

 

FYI - Apply CEGU Probation to OAs

In the context of the Orange County Health Care Agency (HCA), applying the framework of CEGU Probation (Clinical Evaluation & Guidance Unit for youth probation) to OAs (Older Adult Services) involves adapting a highly collaborative, evidence-based behavioral health model designed for structured juvenile justice settings to the specific needs of older adults (aged 60+).

Here is how the core operational pillars of CEGU Probation translate when applied to Older Adult Services (OAs):

1. Collaborative Multidisciplinary Care Teams

CEGU Probation Framework:

Integrates Deputy Probation Officers (DPOs), facility case managers, educators, and clinicians.

Application to OAs:

Pairs behavioral health specialists and psychiatrists with elder care advocates, primary care physicians, and APS (Adult Protective Services) caseworkers to provide a holistic support net.

2. Evidence-Based, Structured Treatment Models

CEGU Probation Framework:

Relies heavily on structured programs like The Matrix Model, CBT, and trauma-informed care.

Application to OAs:

Implements age-appropriate structured behavioral programs—such as Cognitive Behavioral Therapy (CBT) adapted for late-life depression, validation therapy, or specialized substance use programs designed for older adults.

3. Comprehensive Mental Health Screenings & Direct Feedback Logs

CEGU Probation Framework:

Utilizes tools like the MAYSI-2 screening alongside direct feedback forms to instantly track and log clinical data.

Application to OAs:

Deploys standardized senior mental health screenings (such as the Geriatric Depression Scale or MMSE) tied directly to a shared tracking log. This ensures that case managers and medical staff receive immediate clinical feedback regarding cognitive or psychological adjustments.

4. Community Transition & Stabilizing Social Programming

CEGU Probation Framework:

Focuses on community re-entry, growth, and stability through organized social and developmental milestones.

Application to OAs:

Emphasizes aging-in-place initiatives, community reintegration after hospitalization, and targeted socialization events to combat isolation and cognitive decline.

Resistance to Dying Old Man Syndrome (DOM-S) – 15 Items
Satisfaction as an Older Adult (OA)
Quick Score Method
Apply CEGU Probation to OAs material
Buster scores himself relative to two others

NIH Older Adult Satisfaction – 12 Items (Derived)
Predicting V Actual versus Predicting
QSM = Quick Score Method
Scored by and for Keith “Buster” Torkelson, MS
Features of Buster living with two different people

Predicting the satisfaction of older adults’ life

Predicting life satisfaction in older adults involves a combination of psychological, social, health, and economic factors. Recent studies—including machine learning models and long-term developmental tracking—highlight the primary variables that forecast well-being in later life:

 

Life Satisfaction Theory & 4 Contributing Factors (+ Scale) I

Nov 6, 2018

https://positivepsychology.com/life-satisfaction/#:~:text=This%20model%20successfully%20explains%20differences,involved%20in%20quality%20of%20life.

Life Satisfaction in Old Age

Speaking of measuring life satisfaction, let’s take a look at what we know about differences in satisfaction with life. In general, life satisfaction remains relatively high in old age; at least, it’s not all that different from life satisfaction in young people. Although the normal complaints of aging (e.g., aches and pains, sleeping problems) can take away from one’s enjoyment of life, the factors associated with these complaints often lose importance to older adults.

Average life satisfaction may not change much with age, but the contributing factors and how much weight is placed on them certainly does. Older adults do not place as much value on things like status and money as younger people, but they tend to place more value on family relationships and long-term fulfillment from one’s life.  One’s overall physical health can be an important predictor of life satisfaction, but it seems that mental health is likely a much bigger contributor to life satisfaction than physical health in old age (Leyden Academy, n.d.).

Factors Affecting Life Satisfaction among the Elderly

You probably won’t find this surprising, but one of the most influential factors affecting life satisfaction for elderly people is wisdom—defined as having “expert knowledge in the fundamental pragmatics of life,” the tendency towards reflection on one’s own behavior and that of others, and kindness and empathy instead of egotism (Ardelt, 1997).  While physical health, socioeconomic status, and social involvement can play a significant role in life satisfaction for elderly people (and for all people), wisdom was found to be almost twice as influential as the other factors. This is especially true for women, as tests show that physical health is much for important for elderly men than it is for elderly women (Ardelt, 1997).

 

Years from Death

A fascinating study on life satisfaction in older individuals who had already passed explored the impact of a slightly morbid factor—years from death.  You are referring to the psychological and gerontological concept of "terminal decline" in subjective well-being, most famously illustrated by researchers like Denis Gerstorf and his colleagues using longitudinal data from the Berlin Aging Study.

Instead of organizing data by chronological age (time from birth), the researchers aligned the historical data of deceased individuals by their distance-to-death (years from death).

The study yielded several key insights:

Distance-to-death is a better predictor of life satisfaction than actual age. The physical and cognitive declines that occur as a person nears death impact well-being far more than simply getting older.

A clear "change-point" occurs roughly four years before death. Up until that point, individuals generally maintain a stable or only gradually declining level of well-being. Once they hit that four-year window, the drop in life satisfaction doubles in steepness.

For the "oldest old" (85+), the terminal drop is even sharper, accelerating by a factor of three.

Standard health markers don't fully explain it. Traditional predictors like gender, dementia, or the number of illnesses accounted for only a very small fraction of this sudden drop, suggesting that terminal decline is driven by broad, systemic biological changes as the body prepares for the end of life.  This shifting of perspective from "how long have you lived" to "how close are you to the end" fundamentally altered how psychologists look at the curve of happiness in late life.

 

Life Satisfaction Theory & 4 Contributing Factors (+ Scale) II

Nov 6, 2018

https://positivepsychology.com/life-satisfaction/#:~:text=This%20model%20successfully%20explains%20differences,involved%20in%20quality%20of%20life.

The researchers found that changes in life satisfaction were better predicted by years from death than age, indicating that the physical and cognitive decline that often take place as individuals near death are much more impactful on happiness and wellbeing than chronological age (Gerstorf, Ram, Rӧcke, Lindenberger, & Smith, 2008).

Factors of Satisfaction

A more recent study on elderly individuals in China also emphasized the importance of health as a primary determining factor of life satisfaction for older adults (Ng, Tey, & Asadullah, 2017). The total list of important factors included:

• Gender (females +)
• Education (+)
• Place of residence (city + vs. town -)
• Health status (better health +)
• Cognitive ability (+)
• Regular physical examinations (+)
• Perceived relative economic status (+)
• Access to social security provisions (+)
• Commercialized insurances (+)
• Living arrangements (with family members +)
• Number of social services available in the community (+)

 

Interestingly, this study found that self-rated health had more of an impact on life satisfaction than objective measures of health (Ng et al., 2017). This fits with what we know about life satisfaction though—a lot of it comes down to your attitude!

Feature Images

Homeless Older Adult

Same Older Adult Resting on Hard Surface

He Died Soon After These Photos were Taken

He was Under-served

NIH on Older Adults - Satisfaction

Research supported by the National Institutes of Health (NIH) and related studies on aging show that life satisfaction in older adults is a multi-dimensional concept driven heavily by social connections, physical health, psychological well-being, and a sense of purpose.

Key Factors Influencing Older Adult Life Satisfaction

Social Interaction and Family Ties:

For young-old adults (ages 65–74), regular contact with children and participating in volunteer work significantly boost life satisfaction. For older adults aged 75 and older, talking frequently with friends and children, joining hobby clubs, and utilizing senior community centers play a larger role in sustaining happiness.

Aging Satisfaction (Beliefs About Aging):

Longitudinal data from studies like the Health and Retirement Study show that older adults with higher satisfaction with aging experience a lower risk of mortality, increased physical activity, higher positive affect, and significantly lower levels of loneliness.

Physical Health and Exercise:

Regular engagement in physical activity and exercise is one of the strongest modifiable supplemental factors improving life satisfaction. Conversely, high symptom burden (such as chronic pain, fatigue, and sleep problems) directly degrades functional independence and quality of life.

Mental Health and Self-Efficacy:

Personal self-efficacy (an individual's belief in their ability to handle stressors) acts as a crucial psychological buffer against negative life events. Psychological health and strong partner or spousal relationships also heavily influence overall life satisfaction.

Loneliness and Social Isolation:

Chronic loneliness is not just an emotional burden; NIH-supported research links it to accelerated functional decline, mobility loss, and higher risks of mortality in adults over 60.

Related Resources

Explore detailed findings on senior health and communication through the National Institute on Aging.

Review population aging and lifestyle studies via PubMed Central. 

 

“satisfaction survey for older adults”

 

Evaluation Senior Centers, Clubhouses, Wellness Centers and the like
Senior Center Survey Repurposed to MHSA/BHSA WCW
 
Senior Center Interest & Satisfaction Survey
 
Derived from Wilson County, NC (.gov)

https://www.wilsoncountync.gov/departments/senior-center/senior-center-interest-satisfaction-survey

This survey may be anonymous. Fill in the information below only if you want to learn more about our programs or apply for services to older adults.  Please complete this survey if you are more than 59 years old and live in Orange County. For each question, please give your best answer.

 

Do you ever go the Wellness Center West? *

 

• No, I've never been there
• I've been there a few times
• I go the center regularly

 

For those who do not visit the Wellness Center West regularly, what are the reasons that you don't visit the Center? (you may check more than one) *

 

• I do not know much about it
• I do not know where it is
• I do not have transportation
• I do not know anyone who goes there
• I do not think anything there would interest me
• I am too busy
• Other reasons

 

For those who visit the Wellness Center West regularly, what are the reasons that you visit the Center? (you may check more than one) *

 

• To see my friends or not be lonely
• For arts or crafts classes
• To each lunch
• To use fitness equipment or take exercise class
• To play cards, bingo or other games
• To volunteer and help others
• Other reasons

 

Do you think that you will visit the Wellness Center West in the next month?

 

• Yes
• Probably so
• Maybe/Maybe Not
• Probably Not
• No

 

How would you rate the programs and services at the Wellness Center West?

• Excellent
• Good
• Fair
• Poor
• Unsatisfactory

 

Do you have any suggestions to make the Wellness Center West better? If you do not come to the center, is there something the center could do to make you want to come?

More Karaoke Days

 

Promotion - This survey may be anonymous. Fill in the information below only if you want to learn more about our programs or apply for services to older adults. If you prefer not to submit your name and contact information, you may also call the Wellness Center West at (657) 667-6455.

 

• Please email me the center newsletter and calendar of upcoming events
• I would like to come to the center if you can arrange transportation
• I would like to talk to Someone about services for myself or a relative

 

Older People’s Usage Pattern, Satisfaction with Community Facility and Well-Being in Urban Old Districts

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9408318/

By S Wang · 2022 - ‎Abstract

Community facilities are an important element that supports older people’s daily life and promotes their well-being. However, there is a dearth of comprehensive studies on the effect of planning and design of different types of community facilities on older people’s usage patterns and satisfaction. This study aims to provide a framework to explore the relationship among the planning of community facilities, older people’s usage and satisfaction level and well-being for different types of community facilities. Both spatial analysis and questionnaire survey (n = 497) methods are employed in this study. This study finds that commercial (89.34%), municipal (83.10%) and leisure (88.13%) facilities are most commonly used by older people. This study suggests that older people’s frequency of visiting community facilities is mainly affected by the purpose of visiting a community facility. Planning and design quality of the community facility are found to be significantly associated with older people’s satisfaction level with using a community facility. In addition, older people’s higher satisfaction level and usage level of community facilities could increase their physical and psychological well-being. The findings of this study not only contribute to the knowledge gap of older people’s usage and satisfaction with using community facilities but also suggest that planners should aim toward a better distribution of community facilities to improve older adults’ well-being.

 

Facilities

• Commercial
• Community Service
• Cultural
• Municipal
• Leisure
• Religious

 

Longevity - Where you go - What you do

Longevity relies on five core lifestyle pillars backed by scientific research from the Harvard Health Publishing Longevity Guide:

1. Movement

What you do:

Get 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity weekly, plus resistance or strength training at least twice a week. Prioritize leg strength and functional movements like the Sit-To-Stand Test to preserve muscle fiber and balance.

Where you go:

Local gyms, outdoor walking paths, or home workout spaces.

2. Nutrition

What you do:

Focus on whole foods, get adequate protein to prevent muscle loss, and anchor meals with fiber and healthy fats to avoid sharp blood sugar spikes from refined carbohydrates. Emphasize patterns like the Mediterranean diet.

Where you go:

Local grocery stores, farmers' markets, or home kitchens.

3. Sleep

What you do:

Aim for 7 to 8 hours of quality sleep per night. Maintain a consistent wake time every day—including weekends—to support brain waste clearance and metabolic health.

Where you go:

A quiet, dark, and cool bedroom.

4. Stress Reduction

What you do:

Engage in daily movement, regular outdoor daylight exposure, and mindfulness practices to regulate cortisol and systemic inflammation.

Where you go:

Parks, quiet home corners, or community recreation areas.

5. Social Connection

What you do:

Build and maintain intentional, recurring contact with family, friends, and community groups, as strong social ties drastically lower long-term mortality risks.

Where you go:

Community centers, social clubs, family gatherings, or shared-interest groups.

 

Multiple factors associated with life satisfaction in older adults

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297631/

By S Papi · 2021 · Cited by 31

The results of a study by Li et al. showed that life satisfaction in older adults is associated with the level of education, financial resources, self-assessment of health, receiving financial support from the children and satisfying their support, staying at home, seeing and visiting neighbors, and inviting them to dinner. Didino et al. reported that factors such as income, level of home equipment and anxiety and loneliness affect life satisfaction of older adults. Bishop et al. described individual access to key and important life sources as factors influencing life satisfaction.

Data Collection

It was a descriptive-analytical study which has conducted on 679 older adults through convenience sampling from Qom city, Iran during 2018. The data were collected using demographic characteristics, life satisfaction, well-being, cognitive status, social support, and daily activities of life questionnaire.

 

Time Frames

• Adolescents
• Adults
• Babies
• Children
• Older Adults
• Oldest Old
• TAY

 

Person of Interest – Claudia Kawas, MD

https://www.google.com/search?q=kawas+md+oldest+old

AI Overview - Learn more

Claudia Kawas, MD, a geriatric neurologist and researcher at the University of California, Irvine (UCI), is known for her work on aging and dementia, particularly focusing on the "oldest-old" (those over 90) and her leadership of the 90+ Study, a large, longitudinal study of this population.

 

Key Details About Dr. Kawas and Her Research

The 90+ Study:

Initiated in 2003 (building on the earlier Leisure World Cohort Study in Laguna Woods, California), the project follows over 2,000 participants aged 90+ to examine lifestyle, clinical, genetic, and pathological factors influencing long life and brain health.

Major Findings:

Dementia incidence doubles roughly every five years past age 90.

A significant portion of individuals over 90 can harbor brain pathology (such as Alzheimer's-related plaques) yet maintain normal cognition, highlighting high levels of brain resilience. Moderate daily activity, social engagement, and specific lifestyle habits play a major role in survival and functional independence at extreme old age.

Background:

Prior to joining UC Irvine in 2000, Dr. Kawas spent years at the Johns Hopkins University School of Medicine, where she contributed heavily to the Baltimore Longitudinal Study of Aging.

Learn more about her ongoing research through UCI MIND - The 90+ Study or read her biographical overview on Wikipedia - Claudia Kawas.

 

Bios

Dr. Claudia Kawas is a neurologist at the University of California, Irvine, who specializes in the study of aging, particularly focusing on individuals over the age of 90, often referred to as the "oldest-old". Her research, including the "90+ Study," investigates factors that contribute to successful aging and longevity in this population.