Stepping up, stepping out: the elderly customer

long term health care experience

Introduction:
The basic purpose of the study is to maintain and improve quality life of the
elderly people in a specific area. In this purpose long term care services represent some
approaches to meet elder’s health or personal care needs. In this age limit, the people
usually do not give proper time and care to their health. In this purpose, they take some
services from care centers or hospitals. Some of them maintain their health effectively
but most of them don’t feel with these health services.

In this way, long term care services use some approaches and theories to
encourage elderly people to adopt healthier behavior to enhance their social
participation with other people. The purpose of this study is to explore elderly
customer’s long term care experience from two perspectives.

 First, this study attempts to explore how long-term care organizations affect the
extent of social participation among their elderly customers, specifically, this
study adopts Social Cognitive Theory (SCT) and Social Exchange Theory
(SET) to identify two critical psychological states (i.e. self-efficacy and sense of
community) that enhance social participation of the elderly.
 This study explores how care management efforts (i.e. customer education,
perceived organization support, role modeling, perceived other customer support
and diversity of activity) influence psychological states.

 In previous study, review some studies relevant to vulnerable elderly, long term care
services organization and social participation.
 On the basis of previous date, we use both theories SCT and SET to develop a
conceptual social participation model to explain the proposed hypothesis.

Literature Review:
 Both theories Social Cognitive Theory (SCT) and Social Exchange Theory

(SET) are used to review result of elderly people’s health status and satisfaction. Social

cognitive theory describes the influence individual experiences, the actions of others
and environmental factors on individual health behaviors. SCT suggests that individuals’
actions are considerably regulated by perceived self efficacy.

Conceptual Framework:
Customer education, perceived organization support, role modeling, perceived
other customer’s support, diversity of activity are the independent variables in the study,
while self efficacy, sense of community, social participation, service satisfaction, quality
of life are dependent variables. The following have been hypothesized

 H1a. Customer education is positively related to self-efficacy.

 H1b. Customer education is positively related to a sense of community.
 H2a. Perceived organization support is positively related to self efficacy.
 H2b. Perceived organization support is positively related to a sense of
community.
 H3a. Role modeling is positively related to self-efficacy.
 H3b. Role modeling is positively related to a sense of community.
 H4a. Perceived other customer support is positively related to self-efficacy.
 H4b. Perceived other customer support is positively related to a sense of
community.
 H5a. Diversity of activity is positively related to self-efficacy.
 H5b. Diversity of activity is positively related to a sense of community.
 H6. Self-efficacy is positively related to social participation.
 H7. A sense of community is positively related to social participation.
 H8. Social participation is positively related to service satisfaction.
 H9. Social participation is positively related to quality of life.
 H10. Service satisfaction is positively related to quality of life.
 H11. Service satisfaction is negatively related to switching intention.
  H12. Quality of life is negatively related to switching intention.

Methodology:
The data for this study has been obtained through self-administered
questionnaires given to the elderly who were agreed to answer the questionnaire with
their free consent. Some elderly participated after discussing with their families. The
data was gathered from elderly in a self-paid continuing care retirement center located
in southwestern Taiwan. Participants were screened using the Mini mental state
examination (MMSE), who scored below 24 were excluded from the study so that
cognitive deficit may limit their understanding of the questionnaire.

The survey was conducted in two phases. In first phase participants assessed
care management efforts (customer education, perceived organization support, role
modeling, perceived other customer support and diversity of activity) effect on their
psychological states (self efficacy and sense of community) as well as their level of
social participation. Approximately one month later in 2nd phase of the study the
participants responded to their quality of life, service satisfaction and switching intention.
The male participants were 73.5% and female participants were 26.5%.

Results:
Hypothesis Results:

For testing the model and the suggested hypothesis, we examined the
relationships between care management efforts, psychological states and social
participation, as well as those between social participation, quality of life, service
satisfaction and switching intention.

 Customer education is directly related to self-efficacy and sense of community

which proves H1a and H1b true.
 Perceived organization support is directly related to self-efficacy and sense of
community which proves H2a and H2b true.
  Role modeling is directly proportional to self-efficacy and sense of community
which proves H3a and H3b true.
 Perceived other customer support is directly proportional to self-efficacy and
sense of community which proves H4a and H4b true.
 Diversity of activity is directly proportional to self-efficacy and sense of
community which proves H5a and H5b true.
 Self-efficacy is directly related to social participation which proves H6 true.
 A sense of community is directly proportional to social participation which proves
H7 true.
 Social participation is directly proportional to service satisfaction and social
participation which proves H8 and H9 true.
 Service satisfaction is directly related to quality of life which proves H10 true.
 Service satisfaction and quality of life is inversely related to switching intention
which proves H11 and H12 true.

Discussion and conclusion:

This study developed and tested a conceptual model of the relationship among
care management efforts, the elderly psychological states, social participation and
health-related outcomes in long-term care service settings.

The results demonstrate that social participation has significant benefits for both
service satisfaction and quality of life of the elderly, which further decrease their
switching intention. Hence, social participation plays an important role in both the long-
term care experience of elderly customers and the interest of long term care service
organizations.

Applications:
The study has applications for the elderly vulnerable customer to arrive at how
self-efficacy and sense of community developed in them will lead to social participation,
which ultimately proves the quality of life. On the other hand the study has applications
for the service organizations as elderly satisfied customers are the real asset of the
service organizations. The satisfaction of elderly customers will lead to minimal
switching of the customers which is a positive element for the service organizations.