Perceptual and Motor Skills, 1790, 70, 731-738. O Perceptual and Motor Skills 1970
NOTION O F CONTROL A N D SELF-ESTEEM OF INSTITUTIONALIZED OLDER M E N ' USHA CHOWDHARY
University of Missouri-Columbia Summary.-12 institutionalized elderly men (those over 65 yr.) participated in an investigation to assess the influence of concrol on the self-esteem (feelings of selfworth) of the respondents. Langer's 1983 concept of perception of control guided the use of a modified pretest-posttest design. Analysis indicated that having input in decision-making process can enhance institutionalized elderly males' self-esteem and contribute toward improving their quality of life. Possibilities for extending and refining this research are addressed.
Medical professionals who focus on organic pathology of an individual perceive aging as a "process of decremental physical decline" and enforce the stereotype that aging is an illness and abnormal stage of hfe cycle (Estes & Binney, 1989). This stigma guides caregivers' sick-role expectations from their institutionahzed old clients. Professionals from this school of thought believe that older people withdraw socially, are less active and dependent, and lose control over their environment. Based on these assumptions, in longterm-care facihties and f a d e s , independence is discouraged and dependency is nurtured (Hofland, 1988). Generally, caregivers do not trust decision-making skills of their older clients/relatives. Consequently, they either decide themselves or ask those who are giving immediate care to their older client/relatives. Such attempts on caregivers' part result in decreased self-esteem of the institutionahzed elderly (Chowdhary, 1989). Friedson (1970) challenged the sociologists to examine aging from a sociogenic perspective so that solutions other than medical treatment(s) could be developed. The notion of control over the environment is a powerful variable in human and animal behavior (Berkowitz, Waxman, Yaffe, 1988; Langer, 1983; Rodin & Langer, 1980). Loss of choice is reported to promote helplessness (Butler, 1975). Epidemiological research suggests that 30% of the institutionalized and 10% to 45% of those living in communities are depressed (Rotenberg & Hamel, 1988). They also emphasized a negative relationship between depression and life satisfaction, self-esteem and well-being. Langer and Rodin (1976) reported that in care units where choice and personal responsibility are encouraged, residents' alertness, active participation Pre aration of thls manuscript was su ported by grants from Wal-Mart and Center for the of Aging at the University o r Missouri-Columbia. Address correspondence to U. Chowdhary, Department of Textile and Apparel Management, University of Missouri-Columbia, I37 Stanley Hall, Columbia, MO 65211. ;tur$
732
U. CHOWDHARY
and general well-being increase because of their self-determination. Langer (1983) suggested that perception of control over surroundings results in positive psychological and physical consequences. Clothing can be used as one of the several possible means to accomplish this goal. Clothes are the first link between an individual's physical self and the social infrastructure irrespective of sex. Clothes speak about several attributes of people even before they start their conversation. They are individuals' second skins and the nearest portable environment (Horn & Gurel, 1981; Watkins, 1984). They cover the body and enhance one's appearance both physically and emotionally. Because clothes are cultural, people are used to having both standards and choice. By choosing what people want to wear and by manipulating wardrobes, people can make statements about themselves. This is an inexpensive strategy and can be utilized by the institutions as one of the indicators to influence quality of life. In the existing structure, to induce sameness residents' choices are limited in the institutions. Dressing in the institutional attire suppresses individuality and nurtures a sense of loss of control on residents' parts. Also, personal consequences of experiences such as no choice in buying personal belongings, thefts, damaged clothes by careless laundry further devastate elderly persons who grew u p in a society where independence, mastery of environment, the "notion of future with perpetual options" were emphasized (Lawson, 1984, p. 73). Chowdhary (1988) found that an overwhelming majority of older men and women (80%) preferred to wear fashionable clothing. The study was extended to institutionalized elderly women to assess whether receiving clothing that residents' wanted as opposed to something caregivers wanted would influence the self-esteem of institutionahzed elderly women (Chowdhary, 1988). Self-esteem scores increased significantly for those who received what they requested. Conversely, scores dropped for the group who did not receive what they requested. However, none of the previous research focused on older institutionalized men, so it was desirable to examine whether this phenomenon would hold true for institutionalized elderly men (those over 65 yr.) as well. Realizing that all problems cannot be addressed by one research study, the reported work focused on the relationship between clothng option and self-esteem of a small group of institutionalized elderly men.
METHOD A two-group pretest-posttest design was adapted as three phases for conducting the research. Phase I focused on assessing residents' clothing preferences with regard to size, color, fabric, and type. The subjects were randomly divided into two groups based on their self-esteem scores, on an adapted version of Rosenberg's (1965) self-esteem measure, and age to ensure that two groups were equivalent prior to the treatment. Phase I1 involved taking a garment to each of the respondents and identifying his likes and/or dislikes
ELDERLY MEN: CONTROL, SELF-ESTEEM
733
about the garment received, assessing it as an added option in their wardrobe, and documenting change in their self-esteem scores. Phase I11 examined their likes and/or dislikes after the men had owned that garment for two weeks, its frequency of use, and increase or decrease in the self-esteem scores. I n a Veterans Administration Hospital housing 52 residents, 13 qualified and 12 male elderly residents (those over 65 yr.) participated in the study. One who was dropped had some physical problems and needed an interpreter to communicate. Two groups of six men participated. An adapted version of Rosenberg's (1965) self-esteem instrument was used to measure self-esteem at each phase. This adapted version had been used by Chowdhary (1988, 1989) and was reported to give reliable data. Clothing-option measure was adapted from Chowdharyls (1988) instrument to make items appropriate for elderly men. To control for the influence of the "receiving gift" factor one of the groups received what they asked for, and the second group received what the researcher decided would be functional and practical for the residents. Descriptive statistics and paired t tests were applied to the data. A self-pairing technique was used to examine the influence of the treatment. The self-pairing technique involves measuring one individual on two occasions (Snedecor & Cochran, 1967). RESULTS The descriptive analysis indicated that the mean age of the group was 78.4 yr., with a range from 66 to 93 yr. The findings from Phase I showed that a majority of the respondents opted for dress pants or shirts (54%), blue color (57%), and a plain fabric (50%). Polyester/cotton blend was the most preferred fabric. After receiving the garment in Phase 11, all of the participants perceived the garment as an added option in their wardrobes. Also, color (53%) was reported to be the most liked aspect and nothing (69%) as the least liked aspect. The analysis of data in Phase I11 indicated that a majority of the respondents (83%) wore their garment from 1 to 4 times in the following two-week period. A majority of the respondents mentioned color and "everything" (33% each) as the most U e d aspects of the garments received, and "nothing" (50%) as the least liked aspect. Several participants who received Tshitts, longed for a shoulder opening for ease in putting on and taking it off. The findings from paired t tests indicated that self-esteem scores of the respondents improved significantly (t,, = -3.8, p < .01) for all 12 men from Phase I (M = 26.9, SD = 8.3) to Phase I1 (M = 32.2, SD = 4.9); see Fig. 1. Unlike the elderly women of the previous study, the two groups did not differ significantly from each other. A significant increase in mean scores ( p < .05) was observed for both groups. For those who received what they requested, the mean scores increased from 26.8 (SD = 8.5) to 3 1.5 (SD = 3.6;
U. CHOWDHARY
RESIDENTS FIG.1. Changes i n the self-esteem scores of the male residents from Phase I ( W ) to Phase 11 (0)
a
I
U
1
2
3
4
5
6
RESIDENTS
FIG.2. Changes in the self-esteem scores of the male residents who received what they requested from Phase I).( to Phase I1 (0)
t, = -2.5, p c . 0 5 ) ; see Fig. 2. For the group where participants did not receive what they requested, the mean scores boosted from 27.0 (SD= 8.9) to 32.8 (SD= 3.9; t, = -2.6, p < .05); see Fig. 3. The means, standard deviations and ranges are detailed in Table 1. This finding suggests that having residents' input before buying an item of apparel for them, receiving a gift
ELDERLY MEN: CONTROL, SELF-ESTEEM
RESIDENTS FIG. 3. Changes in the self-esteem scores of the male residents who did not receive what they requested from Phase I (m) to Phase I1 (0)
or attention did make participating residents feel good about themselves. A close look at Fig. 1 shows that for a majority of persons, boost was higher for those who had lower self-esteem than those who had higher self-esteem to begin with. This was not evident as clearly among elderly women. This result could reflect regression toward the mean or the fact that persons with TABLE 1 MEANS,STANDARD DEVIATIONS, AND RANGES OF SELF-ESTEF.M SCORES FOR BOTHGROUPSA N D THREEPHASES Grou~
M
SD
Ranne
Phase I Over-all (n = 12) Those who received what they requested (n = 6) Those who did not receive what they requested (n = 6) Phase I1 Over-all (n = 12) Those who received what they requested (n = 6) Those who did not receive what they requested (n = 6) Phase 111 Over-all (n = 12) Those who received what they requested (n = 6) Those who did not receive what they requested (n = 6)
lower self-esteem have more need to exercise means to improve their sense of control for malung themselves feel better than those with higher self-esteem. The latter observation is consistent with Bader's (1983) contention that clothing promotes self-esteem of those who live on ego-support systems. A close look at the Phase I11 of Table 1 shows that although mean scores were
736
U. CHOWDHARY
less than those for the Phase 11, they were higher than Phase I for both groups. This suggests that the impact of receiving did last longer than the day of receiving the article of apparel.
DISCUSSION The following four observations were made from the findings of the simple experiment. First, having residents' input while malung selection for institutionalized men boosted their self-esteem. However, it could not be ascertained what aspect contributed the most: act of receiving, receiving a gift, or having a say in the decision-making process. Second, standard deviation that using scores were smaller in the Phase I1 than Phase I. T h ~ ssuggests this strategy (having residents' input) can contribute toward nurturing the feeling of sameness as well as enhancing self-esteem of the residents. Third, even if all details of a request cannot be addressed, residents' choice of color should be considered because findings indicate that color was the most liked aspect of the apparel received. Fourth, older people prefer clothing like what they wore before they became institutionalized. A majority of the participants preferred to wear dress pants and dress shirts rather than jeans or sweat suits. W i l e comparing the results of this experiment with those of the study of institutionahzed elderly women, the following similarities and differences were found. The three similarities between those groups are given below. First, the older institutionalized women preferred to wear what they were used to wearing before they were institutionalized. Second, color was the most like item by older women also. Both groups like blue the most and this is consistent with what one would expect for the younger generation also. Third, older men longed to have shoulder openings in T-shirts for ease in donning a garment and women longed for a full-length opening for the same purpose. The four differences between these institutionahzed older men and women were as follows. First, the institutionalized older men had lower self-esteem scores (M= 26.9) than the institutionalized older women (M= 36.0). This suggests that the self-esteem of men is more likely to be affected by the restrictions imposed in an institutional setting than that of women. Probably, one can explain this finding based on the traditional role of men who were expected to work independently and outside their homes. The imposed restrictions of the institutional setting can make them feel more of a loss of control of their environment than women who traditionally were expected to stay at home. Second, giving an option alone did not make women feel better unless they received what they wanted because scores dropped for those who did not receive what they requested. However, for men it did not matter what they received as long as their input was considered. Third, a majority of the men considered their spouses' recommendations. However, -
ELDERLY MEN: CONTROL, SELF-ESTEEM
73 7
women did not indicate so. This finding can also be based on the traditional roles of men and women. Since the older people who participated in the study were born prior to 1923, they represented families in which women made most purchases for their whole family. Fourth, older women indicated a concern to have longer sleeves in their garments whereas men did not care one way or the other. The results suggest empirical justification for the proposed linkage between clothing and self-esteem of institutionalized elderly men, and offer a possible coping tool to enhance their psychological selves. Administrators and caregivers can implement this technique to better meet the needs of their clients. Offering a clothing option might be more influential for the institutionalized older people whose food and shelter needs are generally met by the institution than for those who live independently. Exercising this technique close to the established holidays such as Thanksgiving, Christmas, Valentine's, Easter, etc. might prove to be fruitful choices of dates for the administrators, relatives and friends. However, given the small sample size, repeating t h s research in other locations is warranted for improved generalizability. Including personal items (other than clothing) could provide useful information for further understanding of the scope of this relationship. Selecting a site that has a reasonable number of qualified men and women could prove to be a better choice because control for the intersite differences could be maintained while comparing effects of sex of respondents. REFERENCES BADER,I. M. (1983) Clothing. In A. M. Hoffman, W. W. Morris, & I. M. Bader (Eds.), Daily needs and interests of older people. Springfield, IL: Thomas. Pp. 205-218. B ~ ~ ~ o w rM. r zV., , WAXMAN,R., & YAFFE,L. (1988) The effects of a resident self-help model on control, social involvement and set€-esteem among the elderly. The Gerontologist, 28, 620-624. BUTLER,R. N. (1975) Why survive? Being old in America. Evanston, IL: Harper & Row. CAMPBELL, D. T., & STANLEY, J. C. (1963) Experimental and quasi-experimenful designs for research. New York: Springer. CHOWDI-IARY, U. (1988) Self-esteem, age identification, and media exposure of the elderly and Clothing and Textiles Research lournal, 7, 23-30. its relationslup ro fashi~nabilic~. CHOWDHARY, U. (1989) Clothing option: self-esteem and institutionalized elderly. Paper presented at the annual meeting of the American Home Economics Association, Cincinnati, O H . ESTES, C. L., & BINNEY, E. A. (1989) The biomedicalization of aging: dangers and dilemmas. The Gerontologist, 29, 587-596. FRIEDSON,E. (1970) Profession of medicine. New York: Dodd, Mead. HOFLAND, B. F. (1988) Autonomy in long-term care: background issues and a pragmatic response. The Gerontologist, 28(SuppI.), 3-9. HORN,M. H., & GUREL,L. M. (1981) The second skin: an interdisciplinary study of clothing. Boston, MA: Houghton Miffin. KERR, E. W. (1987) A guide to selecting a nursing home in Missouri. Columbia, MO: Central Missouri Area Agency on A g ~ n g LANGER, E. J. (1983) The psychology o/control. Beverly Hills, CA: Sage.
738
U. CHOWDHARY
LANGER, E. J., & RODIN,J. (1976) The effect of choice and enhanced personal responsibility for the aged: a field experiment in an institutional setting. Journal of Personality and Social Psychology, 34, 191-198. LAWSON, I. R. (1984) Humanistic geriatric care: a context of antithesis. In S. F. Spicker & S. R. Ingman (Eds.), Vitaljzing long-term care: the teaching nursing home and other perspectives. New York: Springer. Pp. 73-80. LYMAN,K. A. (1989) Bringing the social back in: a critique of the biomedicalization of dementia. The Gerontologist, 29, 597-605. PENSIERO,M., & ADAMS,M. (1987) Dress and self-esteem. Journal of Gerontological Nuning, 13, 10-17. ROSENBERG, M. (1965) S o c i e ~and adolescent self-image. Princeton, NJ: Princeton Univer. Press. ROTTENBERG, K. J., & HAMEL, J. (1988) Social interaction and depression in elderly individuals. International Journal of Aging and Human Development, 27, 305-317. SNEDECOR, G. W., & COCFRAN, W. G. (1967) Statistical methods. Ames, IA: The Iowa State Press. WATKMS,S. M. (1984) Clothing: the portable environment. Ames, IA: The Iowa State Press.
Accepted March 18, 1970.
NOTION O F CONTROL A N D SELF-ESTEEM OF INSTITUTIONALIZED OLDER M E N ' USHA CHOWDHARY
University of Missouri-Columbia Summary.-12 institutionalized elderly men (those over 65 yr.) participated in an investigation to assess the influence of concrol on the self-esteem (feelings of selfworth) of the respondents. Langer's 1983 concept of perception of control guided the use of a modified pretest-posttest design. Analysis indicated that having input in decision-making process can enhance institutionalized elderly males' self-esteem and contribute toward improving their quality of life. Possibilities for extending and refining this research are addressed.
Medical professionals who focus on organic pathology of an individual perceive aging as a "process of decremental physical decline" and enforce the stereotype that aging is an illness and abnormal stage of hfe cycle (Estes & Binney, 1989). This stigma guides caregivers' sick-role expectations from their institutionahzed old clients. Professionals from this school of thought believe that older people withdraw socially, are less active and dependent, and lose control over their environment. Based on these assumptions, in longterm-care facihties and f a d e s , independence is discouraged and dependency is nurtured (Hofland, 1988). Generally, caregivers do not trust decision-making skills of their older clients/relatives. Consequently, they either decide themselves or ask those who are giving immediate care to their older client/relatives. Such attempts on caregivers' part result in decreased self-esteem of the institutionahzed elderly (Chowdhary, 1989). Friedson (1970) challenged the sociologists to examine aging from a sociogenic perspective so that solutions other than medical treatment(s) could be developed. The notion of control over the environment is a powerful variable in human and animal behavior (Berkowitz, Waxman, Yaffe, 1988; Langer, 1983; Rodin & Langer, 1980). Loss of choice is reported to promote helplessness (Butler, 1975). Epidemiological research suggests that 30% of the institutionalized and 10% to 45% of those living in communities are depressed (Rotenberg & Hamel, 1988). They also emphasized a negative relationship between depression and life satisfaction, self-esteem and well-being. Langer and Rodin (1976) reported that in care units where choice and personal responsibility are encouraged, residents' alertness, active participation Pre aration of thls manuscript was su ported by grants from Wal-Mart and Center for the of Aging at the University o r Missouri-Columbia. Address correspondence to U. Chowdhary, Department of Textile and Apparel Management, University of Missouri-Columbia, I37 Stanley Hall, Columbia, MO 65211. ;tur$
732
U. CHOWDHARY
and general well-being increase because of their self-determination. Langer (1983) suggested that perception of control over surroundings results in positive psychological and physical consequences. Clothing can be used as one of the several possible means to accomplish this goal. Clothes are the first link between an individual's physical self and the social infrastructure irrespective of sex. Clothes speak about several attributes of people even before they start their conversation. They are individuals' second skins and the nearest portable environment (Horn & Gurel, 1981; Watkins, 1984). They cover the body and enhance one's appearance both physically and emotionally. Because clothes are cultural, people are used to having both standards and choice. By choosing what people want to wear and by manipulating wardrobes, people can make statements about themselves. This is an inexpensive strategy and can be utilized by the institutions as one of the indicators to influence quality of life. In the existing structure, to induce sameness residents' choices are limited in the institutions. Dressing in the institutional attire suppresses individuality and nurtures a sense of loss of control on residents' parts. Also, personal consequences of experiences such as no choice in buying personal belongings, thefts, damaged clothes by careless laundry further devastate elderly persons who grew u p in a society where independence, mastery of environment, the "notion of future with perpetual options" were emphasized (Lawson, 1984, p. 73). Chowdhary (1988) found that an overwhelming majority of older men and women (80%) preferred to wear fashionable clothing. The study was extended to institutionalized elderly women to assess whether receiving clothing that residents' wanted as opposed to something caregivers wanted would influence the self-esteem of institutionahzed elderly women (Chowdhary, 1988). Self-esteem scores increased significantly for those who received what they requested. Conversely, scores dropped for the group who did not receive what they requested. However, none of the previous research focused on older institutionalized men, so it was desirable to examine whether this phenomenon would hold true for institutionalized elderly men (those over 65 yr.) as well. Realizing that all problems cannot be addressed by one research study, the reported work focused on the relationship between clothng option and self-esteem of a small group of institutionalized elderly men.
METHOD A two-group pretest-posttest design was adapted as three phases for conducting the research. Phase I focused on assessing residents' clothing preferences with regard to size, color, fabric, and type. The subjects were randomly divided into two groups based on their self-esteem scores, on an adapted version of Rosenberg's (1965) self-esteem measure, and age to ensure that two groups were equivalent prior to the treatment. Phase I1 involved taking a garment to each of the respondents and identifying his likes and/or dislikes
ELDERLY MEN: CONTROL, SELF-ESTEEM
733
about the garment received, assessing it as an added option in their wardrobe, and documenting change in their self-esteem scores. Phase I11 examined their likes and/or dislikes after the men had owned that garment for two weeks, its frequency of use, and increase or decrease in the self-esteem scores. I n a Veterans Administration Hospital housing 52 residents, 13 qualified and 12 male elderly residents (those over 65 yr.) participated in the study. One who was dropped had some physical problems and needed an interpreter to communicate. Two groups of six men participated. An adapted version of Rosenberg's (1965) self-esteem instrument was used to measure self-esteem at each phase. This adapted version had been used by Chowdhary (1988, 1989) and was reported to give reliable data. Clothing-option measure was adapted from Chowdharyls (1988) instrument to make items appropriate for elderly men. To control for the influence of the "receiving gift" factor one of the groups received what they asked for, and the second group received what the researcher decided would be functional and practical for the residents. Descriptive statistics and paired t tests were applied to the data. A self-pairing technique was used to examine the influence of the treatment. The self-pairing technique involves measuring one individual on two occasions (Snedecor & Cochran, 1967). RESULTS The descriptive analysis indicated that the mean age of the group was 78.4 yr., with a range from 66 to 93 yr. The findings from Phase I showed that a majority of the respondents opted for dress pants or shirts (54%), blue color (57%), and a plain fabric (50%). Polyester/cotton blend was the most preferred fabric. After receiving the garment in Phase 11, all of the participants perceived the garment as an added option in their wardrobes. Also, color (53%) was reported to be the most liked aspect and nothing (69%) as the least liked aspect. The analysis of data in Phase I11 indicated that a majority of the respondents (83%) wore their garment from 1 to 4 times in the following two-week period. A majority of the respondents mentioned color and "everything" (33% each) as the most U e d aspects of the garments received, and "nothing" (50%) as the least liked aspect. Several participants who received Tshitts, longed for a shoulder opening for ease in putting on and taking it off. The findings from paired t tests indicated that self-esteem scores of the respondents improved significantly (t,, = -3.8, p < .01) for all 12 men from Phase I (M = 26.9, SD = 8.3) to Phase I1 (M = 32.2, SD = 4.9); see Fig. 1. Unlike the elderly women of the previous study, the two groups did not differ significantly from each other. A significant increase in mean scores ( p < .05) was observed for both groups. For those who received what they requested, the mean scores increased from 26.8 (SD = 8.5) to 3 1.5 (SD = 3.6;
U. CHOWDHARY
RESIDENTS FIG.1. Changes i n the self-esteem scores of the male residents from Phase I ( W ) to Phase 11 (0)
a
I
U
1
2
3
4
5
6
RESIDENTS
FIG.2. Changes in the self-esteem scores of the male residents who received what they requested from Phase I).( to Phase I1 (0)
t, = -2.5, p c . 0 5 ) ; see Fig. 2. For the group where participants did not receive what they requested, the mean scores boosted from 27.0 (SD= 8.9) to 32.8 (SD= 3.9; t, = -2.6, p < .05); see Fig. 3. The means, standard deviations and ranges are detailed in Table 1. This finding suggests that having residents' input before buying an item of apparel for them, receiving a gift
ELDERLY MEN: CONTROL, SELF-ESTEEM
RESIDENTS FIG. 3. Changes in the self-esteem scores of the male residents who did not receive what they requested from Phase I (m) to Phase I1 (0)
or attention did make participating residents feel good about themselves. A close look at Fig. 1 shows that for a majority of persons, boost was higher for those who had lower self-esteem than those who had higher self-esteem to begin with. This was not evident as clearly among elderly women. This result could reflect regression toward the mean or the fact that persons with TABLE 1 MEANS,STANDARD DEVIATIONS, AND RANGES OF SELF-ESTEF.M SCORES FOR BOTHGROUPSA N D THREEPHASES Grou~
M
SD
Ranne
Phase I Over-all (n = 12) Those who received what they requested (n = 6) Those who did not receive what they requested (n = 6) Phase I1 Over-all (n = 12) Those who received what they requested (n = 6) Those who did not receive what they requested (n = 6) Phase 111 Over-all (n = 12) Those who received what they requested (n = 6) Those who did not receive what they requested (n = 6)
lower self-esteem have more need to exercise means to improve their sense of control for malung themselves feel better than those with higher self-esteem. The latter observation is consistent with Bader's (1983) contention that clothing promotes self-esteem of those who live on ego-support systems. A close look at the Phase I11 of Table 1 shows that although mean scores were
736
U. CHOWDHARY
less than those for the Phase 11, they were higher than Phase I for both groups. This suggests that the impact of receiving did last longer than the day of receiving the article of apparel.
DISCUSSION The following four observations were made from the findings of the simple experiment. First, having residents' input while malung selection for institutionalized men boosted their self-esteem. However, it could not be ascertained what aspect contributed the most: act of receiving, receiving a gift, or having a say in the decision-making process. Second, standard deviation that using scores were smaller in the Phase I1 than Phase I. T h ~ ssuggests this strategy (having residents' input) can contribute toward nurturing the feeling of sameness as well as enhancing self-esteem of the residents. Third, even if all details of a request cannot be addressed, residents' choice of color should be considered because findings indicate that color was the most liked aspect of the apparel received. Fourth, older people prefer clothing like what they wore before they became institutionalized. A majority of the participants preferred to wear dress pants and dress shirts rather than jeans or sweat suits. W i l e comparing the results of this experiment with those of the study of institutionahzed elderly women, the following similarities and differences were found. The three similarities between those groups are given below. First, the older institutionalized women preferred to wear what they were used to wearing before they were institutionalized. Second, color was the most like item by older women also. Both groups like blue the most and this is consistent with what one would expect for the younger generation also. Third, older men longed to have shoulder openings in T-shirts for ease in donning a garment and women longed for a full-length opening for the same purpose. The four differences between these institutionahzed older men and women were as follows. First, the institutionalized older men had lower self-esteem scores (M= 26.9) than the institutionalized older women (M= 36.0). This suggests that the self-esteem of men is more likely to be affected by the restrictions imposed in an institutional setting than that of women. Probably, one can explain this finding based on the traditional role of men who were expected to work independently and outside their homes. The imposed restrictions of the institutional setting can make them feel more of a loss of control of their environment than women who traditionally were expected to stay at home. Second, giving an option alone did not make women feel better unless they received what they wanted because scores dropped for those who did not receive what they requested. However, for men it did not matter what they received as long as their input was considered. Third, a majority of the men considered their spouses' recommendations. However, -
ELDERLY MEN: CONTROL, SELF-ESTEEM
73 7
women did not indicate so. This finding can also be based on the traditional roles of men and women. Since the older people who participated in the study were born prior to 1923, they represented families in which women made most purchases for their whole family. Fourth, older women indicated a concern to have longer sleeves in their garments whereas men did not care one way or the other. The results suggest empirical justification for the proposed linkage between clothing and self-esteem of institutionalized elderly men, and offer a possible coping tool to enhance their psychological selves. Administrators and caregivers can implement this technique to better meet the needs of their clients. Offering a clothing option might be more influential for the institutionalized older people whose food and shelter needs are generally met by the institution than for those who live independently. Exercising this technique close to the established holidays such as Thanksgiving, Christmas, Valentine's, Easter, etc. might prove to be fruitful choices of dates for the administrators, relatives and friends. However, given the small sample size, repeating t h s research in other locations is warranted for improved generalizability. Including personal items (other than clothing) could provide useful information for further understanding of the scope of this relationship. Selecting a site that has a reasonable number of qualified men and women could prove to be a better choice because control for the intersite differences could be maintained while comparing effects of sex of respondents. REFERENCES BADER,I. M. (1983) Clothing. In A. M. Hoffman, W. W. Morris, & I. M. Bader (Eds.), Daily needs and interests of older people. Springfield, IL: Thomas. Pp. 205-218. B ~ ~ ~ o w rM. r zV., , WAXMAN,R., & YAFFE,L. (1988) The effects of a resident self-help model on control, social involvement and set€-esteem among the elderly. The Gerontologist, 28, 620-624. BUTLER,R. N. (1975) Why survive? Being old in America. Evanston, IL: Harper & Row. CAMPBELL, D. T., & STANLEY, J. C. (1963) Experimental and quasi-experimenful designs for research. New York: Springer. CHOWDI-IARY, U. (1988) Self-esteem, age identification, and media exposure of the elderly and Clothing and Textiles Research lournal, 7, 23-30. its relationslup ro fashi~nabilic~. CHOWDHARY, U. (1989) Clothing option: self-esteem and institutionalized elderly. Paper presented at the annual meeting of the American Home Economics Association, Cincinnati, O H . ESTES, C. L., & BINNEY, E. A. (1989) The biomedicalization of aging: dangers and dilemmas. The Gerontologist, 29, 587-596. FRIEDSON,E. (1970) Profession of medicine. New York: Dodd, Mead. HOFLAND, B. F. (1988) Autonomy in long-term care: background issues and a pragmatic response. The Gerontologist, 28(SuppI.), 3-9. HORN,M. H., & GUREL,L. M. (1981) The second skin: an interdisciplinary study of clothing. Boston, MA: Houghton Miffin. KERR, E. W. (1987) A guide to selecting a nursing home in Missouri. Columbia, MO: Central Missouri Area Agency on A g ~ n g LANGER, E. J. (1983) The psychology o/control. Beverly Hills, CA: Sage.
738
U. CHOWDHARY
LANGER, E. J., & RODIN,J. (1976) The effect of choice and enhanced personal responsibility for the aged: a field experiment in an institutional setting. Journal of Personality and Social Psychology, 34, 191-198. LAWSON, I. R. (1984) Humanistic geriatric care: a context of antithesis. In S. F. Spicker & S. R. Ingman (Eds.), Vitaljzing long-term care: the teaching nursing home and other perspectives. New York: Springer. Pp. 73-80. LYMAN,K. A. (1989) Bringing the social back in: a critique of the biomedicalization of dementia. The Gerontologist, 29, 597-605. PENSIERO,M., & ADAMS,M. (1987) Dress and self-esteem. Journal of Gerontological Nuning, 13, 10-17. ROSENBERG, M. (1965) S o c i e ~and adolescent self-image. Princeton, NJ: Princeton Univer. Press. ROTTENBERG, K. J., & HAMEL, J. (1988) Social interaction and depression in elderly individuals. International Journal of Aging and Human Development, 27, 305-317. SNEDECOR, G. W., & COCFRAN, W. G. (1967) Statistical methods. Ames, IA: The Iowa State Press. WATKMS,S. M. (1984) Clothing: the portable environment. Ames, IA: The Iowa State Press.
Accepted March 18, 1970.
