This study attempted to identify the degree of ability of rural elderly people to conduct the activities of daily living, their depression levels, and life satisfaction, and identify the correlation between these variables and the factors affecting life satisfaction.
As of 2018, elderly people living alone accounted for 19.4% [22] of the population of Korea, compared to 60.1% found in this study, which is three times higher. The national statistics were derived by combining the rates in urban and rural areas, and the ratio of elderly people living alone in rural areas was twice as high as that in urban areas [7]. However, this study was conducted on participants living in rural areas to demonstrate that the aging of rural areas is a serious issue. This raises the importance of policies focusing on elderly people living alone in rural areas when establishing measures to improve life satisfaction for the elderly population.
The study results showed that the ability to conduct the activities of daily living was poor if the level of education was low, and the ability of elderly people living alone was worse than that of elderly people living with their spouses. These results were consistent with the current status of functional state restrictions for senior citizens presented by Statistics Korea [23]. Therefore, for the physical health of the elderly in rural areas with a large number of senior citizens living alone, social support systems and activity programs are necessary to improve the ability of seniors to perform the activities of daily living, especially for elderly people living alone.
Depression was significantly higher in elderly women than in men, and higher age and lower education levels were associated with depression, consistent with studies by Jung [24] and Statistics Korea [25]. In addition, this study found that the level of depression among senior citizens living alone was higher than that of senior citizens living with their children, consistent with the report by Statistics Korea [25] that elderly people living alone had the highest level of depression. Depression increases in older people when social participation is low, social networks are low, or social support is cut off [26]. Therefore, social participation, the expansion of relationship networks, and social interest and support for the elderly in rural areas are required.
The level of life satisfaction was high for younger seniors and those with a high level of education. This was an opposite result from that reported by Jung [24], which supported the research of Park and Hur [16] and Bang [27] on city-dwelling elderly people but studied seniors in the hospital. In this study, Protestantism had significantly associated with higher life satisfaction than that of the non-religious participants. The results supported a prior study [16, 17] that reported that people with religion were more satisfied than those without religion. This is believed to be because religious values and beliefs, forgiveness, and religious support help to ease and overcome the problems experienced by elderly people. Elderly people living with their children were found to be more satisfied than those living alone, which supported the findings of Park and Hur [16]. Elderly people living with their children and spouses probably have a higher level of satisfaction with their lives because of the higher level of support and care from their families than those of seniors living alone. Therefore, community and volunteer support systems and programs that can replace the closeness and care of the family are required to improve the life satisfaction of elderly people not cohabitating with their families.
Park and Hur [16], and Bang [27] conducted studies of urban senior citizens and reported that the participants’ ability to perform the activities of daily living was positively associated with depression, while their life satisfaction level was negatively related to depression and the ability to perform the activities of daily living. In other words, fewer restrictions on daily activities mean fewer problems with daily activities and fewer bad health conditions, supporting previous studies [16, 17] that reported good health conditions led to low depression and high life satisfaction. These results are thought to be related to the physical, mental, social, and economic conditions of the elderly rather than the results of the differences between urban and rural areas. In addition, most of the participants in this study have lived in rural areas by performing physical labor, and although the amount of labor has decreased, they continue to carry out physical daily life activities such as gardening, so there are not many restrictions on their daily activities. The result is that they have continued to participate in social life where they like to eat together in one room and enjoy hobbies [8].
In this study, the greatest influences on life satisfaction were in the order of depression, religion, and the ability to perform daily activities, and the model's ability to explain the differences was 41.0%. This supports Park and Hur’s findings [16] that depression was the biggest factor in life satisfaction and that religion affects the activities of daily living, confirming the significant impact on the life satisfaction of elderly people, regardless of differences between living in urban and rural areas. In addition, a prior study [28] supported that depression had the greatest impact on life satisfaction, and that the ability to perform daily activities was important to maintaining or lowering the level of life satisfaction of the elderly [16], and that religion was important in life, increasing the level of life satisfaction and helping seniors adapts well to life. This leads to psychological depression as elderly people become more vulnerable [5], and it is likely that expressing their beliefs in God and participating in religious activities will help them feel happy [28]. This sense of happiness is thought to reduce the chances of depression among the elderly and help them adapt to life in their old age. These findings confirm that the continuous provision of programs such as education and weekly communal living activities, which can ease depression and restrictions on physical activities, are necessary to enhance the life satisfaction of the elderly, especially if religious participation programs are also provided.
Elderly people are likely to experience symptoms of loneliness and depression due to tendencies for declines in physical ability, their ability to perform the activities of daily living, and their participation in social activities [1]. Furthermore, depression has a strong negative effect on seniors’ satisfaction with life [16, 27]. Thus, providing education can help seniors adjust to changes in their lives, reducing and alleviating depression, and physical activity programs and participation in spiritual activities can provide support for emotional problems. And for the elderly in rural areas who lack housing, welfare means, and social support, the experience of communal weekly life has the effect of forming interdependencies, promoting and coordinating coping mechanisms, expanding their sense of belonging to the community, and providing spiritual stability by expanding their social support network. Therefore, the study confirmed [29] that sharing common living facilities can help seniors rely on each other and relieve loneliness by saving living expenses and forming close relationships with neighbors for social support, thereby helping to reduce depression and increase life satisfaction among elderly people in rural areas who lack support from their families and children. The study also confirmed that the social support of the Rural Day Group Home played an important role in keeping the minds and bodies of vulnerable rural seniors healthy. Therefore, expansion of the Rural Day Group Home social network can maintain the safety and health of rural seniors and form mutual care relationships by reviving the unique sense of community and expanding the functions of communal living, which should lower depression and enhance the life satisfaction of rural seniors. In addition, the results of this study confirmed the influence of religion on the life satisfaction of the elderly in rural areas, suggesting a possible synergistic effect in enhancing the life satisfaction level if programs for spiritual participation were added to those in the Rural Day Group Homes.