No country for old men? The role of a ‘Gentlemen's Club’ in promoting social engagement and psychological well-being in residential care

Abstract

Objective: Social isolation is a common problem in older people who move into care that has negative consequences for well-being. This is of particular concern for men, who are marginalised in long-term care settings as a result of their reduced numbers and greater difficulty in accessing effective social support, relative to women. However, researchers in the social identity tradition argue that developing social group memberships can counteract the effects of isolation. We test this account in this study by examining whether increased socialisation with others of the same gender enhances social identification, well-being (e.g. life satisfaction, mood), and cognitive ability.

Method: Care home residents were invited to join gender-based groups (i.e. Ladies and Gentlemen's Clubs). Nine groups were examined (five male groups, four female groups) comprising 26 participants (12 male, 14 female), who took part in fortnightly social activities. Social identification, personal identity strength, cognitive ability and well-being were measured at the commencement of the intervention and 12 weeks later.

Results: A clear gender effect was found. For women, there was evidence of maintained well-being and identification over time. For men, there was a significant reduction in depression and anxiety, and an increased sense of social identification with others.

Conclusion: While decreasing well-being tends to be the norm in long-term residential care, building new social group memberships in the form of gender clubs can counteract this decline, particularly among men.

Keywords:

• social support
• quality of life
• depression
• social identity
• gender

Acknowledgements

Work on this article was supported by a grant from the Economic and Social Research Council (RES-062-23-0135) awarded to the second and fourth authors and a British Academy Small Grant (SG-52142) to the first three authors. The authors thank Pamela Bretschneider, Kathryn Bristow, Jo Hague and Sonya Saroyan for help with the data collection. We are grateful to staff and residents of Cornwall Care Limited for allowing us to conduct this research and for their help in the facilitating the study.

Notes

Notes

1. More men were members of the gender-based group (n = 2) but not available for data collection due to ill health.

2. While multivariate analysis of variance (MANOVA) is often used instead of repeated analysis of variance, the sample size in this study was relatively small and hence the power of this analysis would be limited. Accordingly, we followed the practice of previous similar studies (Haslam et al., 2010; Jetten et al., 2010) and conducted a series of univariate ANCOVAs to test the particular effects we predicted as opposed to a single MANOVA (Huberty & Morris, 1989).

3. All pairwise comparisons are based on Bonferroni adjustments for multiple comparisons.

4. The Bonferroni adjusted p-value for the well-being measures is 0.013. A Bonferroni correction accounts for a possible alpha inflation because of our multiple testing and uses a family-wise error adjustment. The usefulness of this correction and the interpretation are considered disputable. For example, adjusting for the Type 1 error decreases power and increases the risk for a Type II (or false–negative results; Feise, 2002; Perneger, 1998). To disentangle this dilemma, and to lower the alpha level and maintain the beta level at the same time, we would need to increase the sample size, which was not possible in this study and thus limits the conclusions we can draw from this study.

5. A score of 0–7 represents no anxiety/depression, 8–10 mild, 11–14 moderate and 15–21 severe anxiety/depression. A score of 8 or more is recommended for use in the UK National Health Service to represent the presence of depressive symptomatology (Westoby et al., 2009).