Most notable welfare countries and governments strive to guarantee happiness by drawing up and implementing various policies to support the goal of ‘improving the life satisfaction, quality of life (QoL) or well-being’ with the aim of raising the level of happiness of the people. Examining at the policy goals of Korean welfare programs for older adults, the importance of the concept of life satisfaction is clearly revealed. You can see that in most cases, the policy goal of this project is focused on “the QoL of older adults” and that “life satisfaction” serves as a core element in attaining “QoL”. Accordingly, every policy in Korea regarding the elderly emphasizes life satisfaction as an important social task, and seeks to raise it for the elderly . The type of activity and time use can never be separated because they are important criteria in determining lifestyle, improvement of life, and even life satisfaction . This does not refer merely to life extension but to exercising control over one's life based on healthy life in old age. Successful aging is possible when a person lives a proper life in balance with occupations .
The Republic of Korea (ROK) has become an aging society later than Europe and Japan. But as 2050 approaches, the proportion of the ROK population aged 65 and over will surge, and it is predicted that Korea will become a world-class super-aged society. The society of the ROK, which has just become an aging society, urgently needs to solve various problems faced by older adults who have psychological anxiety due to loss of body function and income reduction . As the size of the older adults group increases and its influence grows with the aging of the society, the analysis of the use pattern of living time has a great social significance . Management should be planned regarding the balance of self-care, work, leisure, and relaxation to enhance life satisfaction and health .
According to the Survey of Household Finance and Welfare (2017) by the Korea National Statistical Office (KOSTAT), the average retirement age of householders in Korea is 62.1 years old, which means they have to live for more than 20 years without regular income after retirement . In 2016, only 7.1% of the Korean population were pension recipients, but this reflects a steady increase from 3.0% in 2013 and 4.38% in 2014. This indicates retirees have been recognizing the importance of regular cash flow by gradation . Unlike other countries, in Korea, National Health Service (NHS) spending occupies a strictly high proportion of the public medical security system.
The medical expenditure of older adults for health insurance rose very rapidly from 2010 to 2016, in proportion to the growing population of the aged. In 2016, there were 6.45 million people aged 65 or over that received national health care benefits, accounting for 12.7% of the whole population. The medical expenditure was 25 trillion 18.7 billion KRW, accounting for 58.7% of their entire expenditure. The monthly average medical expenditure per capita among those aged 65 or over was 3.1 times greater than the monthly average medical expenditure of the whole population . Therefore, it is possible to provide evidence supporting the intervention of time use and for developing programs by ascertaining the patterns of time use by older Korean adults in their living after retirement and determining the correlation between this, health and life satisfaction.
Time use is employed to evaluate occupational balance (OB). OB refers to a status wherein labor, rest and the amounts of time for labor and rest are distributed at an appropriate ratio and occupational imbalance (OI) occurs when the excessive use of time in one area worsens health or the quality of life [10, 11]. OB refers to a balanced participation by individuals in their daily occupational life . In the study by Matuska and Christiansen, OB refers to a condition in which a person can live a healthy and meaningful life in a given day-to-day occupational life . Maintaining a good balance of occupation means using living time in the activity areas that one needs in an appropriate distribution. OB perceived by an individual is likely to be influenced by the amount of time spent in everyday occupation. Time-use is used to evaluate OB and occupational engagement . If the OI is precipitated by a time imbalance, the level of health and life satisfaction will deteriorate. Therefore, the time use of the subjects should be grasped and should be included in any goal setting and intervention. The OI causes the imbalance of the remaining activity areas as a result of a one-sided occupational performance pattern, which can ultimately deteriorate the life satisfaction and health, lead to impairment or disease and hinder successful aging . Therefore, understanding time use is necessary in assessing the OB, which shows how to choose mandatory and non-mandatory activities according to the value of an individual [14, 16].
Effective time use shows good time management and outstanding self-management skills. These self-management skills balance a person’s needs and emotions and include proper management of temporal demands . The study of 24 hours of living time can allow us to grasp the everyday life of an individual and the social structure around the individual. In particular, this temporal approach is suitable for dealing with the daily living of older adults, which is difficult to grasp by other official and economic approaches .
In the research comparing time use between older Korean adults and older foreign adults, older Korean adults spent the greatest number of hours in IADL among the seven activity areas other than rest and sleep. They spent the greatest portion of the day doing IADL, including housework and taking care of grandchildren and family members. This was followed by leisure and work. They primarily spent their leisure time using media and the majority of work was unpaid family affairs or volunteer work, not paid work.
Based on the results of American Time Use Surveys (ATUS), older adults in the US spent the greatest number of hours in leisure among the seven activity areas other than rest and sleep The older adults in the US spent time engaged in diverse sports activities like playing golf, walking and swimming and leisure activities, including using media . This was followed by IADL activities such as housework and gardening, and social activities to connect with family members and friends. But they spent very little time on working, playing or learning .
Occupation is an activity that has a unique meaning and purpose in the life of an individual and is at the center of individual identity and competence, which influences the individual in spending time and making decisions . Occupation is important enough to be considered as a part of a life description, and experiencing meaningful occupation has a positive impact on health . Occupation is very critical to human beings and occupation and time have an inseparable relationship with each other, since people are involved in occupations every hour . Participation involves the balance of activities as well as diversity, meaning, and social factors of everyday use . In order to determine the relationship between occupational engagement and health, occupational therapists have studied various concepts where OB is one of the important concepts. Experience of meaningful occupation has a positive impact on health and therefore, participating in a task successfully reflects the subjective value of an individual .
OB is very important to human beings and for older adults, maintaining OB adequately is directly connected to good health. This motivates humans to plan and manage their lives for quality. In particular, people who are not sufficiently provided with an opportunity to work suffer damaged health and eventually they have a difficulty surviving. This demonstrates that OI may cause damage to health or a disease by worsening qualitative aspects of health and life . Countries, therefore, need to be more aggressive in providing environments for older adults to improve their life satisfaction by maintaining OB or in establishing and enforcing older adults health care policies by developing health programs considering the physical abilities of older adults or by cultivating specialists .
Studies on time use and life satisfaction in the ROK’s occupational therapy field have mainly focused on spinal cord injury, schizophrenia, multiple sclerosis and rheumatoid arthritis patients . Time use and life satisfaction programs are reported to have a positive effect on the recovery of various functions by numerous chronic and severely handicapped persons as well as normal people . Kim, Lee, and Jeon reported that they applied a lifestyle re-design program to older adults with dementia to improve their productivity as well as their life satisfaction . There was a systematic review of time use that analyzed the amount of time use through a survey of the time spent by healthy elders, analyzing the changes in time use by age and by year according to the occupation of South Koreans and so on .
In early studies in Korea and abroad, those on the occupational balance analyzed how time use varies in labor, self-management, and leisure . In many studies, the OB has been dealt with in the sense of personally perceived balance [14, 30]. Bejerholm and Eklund analyzed that the time use of schizophrenic patients revealed a pattern that caused problems in their performance, and suggested that time management specialists should provide these clients with mediation to support their effective time use .
Activity theory explains that individuals accomplish successful aging when they maintain proper social activities. That is, life satisfaction is higher as older adults find activities which can serve as substitutes for personal goals they had desired to attain in their occupation and life before reaching senility and as they are actively engrossed in such activities. This theory is made up of four pillars - social activity (the quantity of and the individual’s interaction), social adequacy (the quality of an individual’s social interaction as expressed in feelings of loneliness or its opposite), self-conception (the individual’s image of his own worth as a person), life satisfaction (relative happiness with present circumstances in the context of one’s lifetime experiences). It was supposed that the four pillars, making both direct and indirect influence, form a causal chain in the order given .
Conversely, disengagement theory argues that social individuals are progressively separate from or drop out of the role system of middle age, as they enter old age and that this is a universal and indispensable process for the maintenance and sustainable development of the social system. Continuity theory remedies the weaknesses of the two conflicting theories; activity theory and disengagement theory and says a good social activity in old age continuously performs a similar role, focusing on personal disposition and the role performed in middle age. This continuity theory is presented as a conceptual indicator of social activities for the aged .
Currently, it is necessary to provide supporting data to determine elders’ health promotion and health care policy by verifying the OB through the living time of older adults. However, there are still few studies on the life satisfaction of older adults in the ROK after dividing the OB group and the OI group. For the OB group, all of eight activity areas are included in the scope of standard deviation, based on the mean value of life time. The OI group includes cases where even one of the areas is beyond the scope of standard deviation .
The purpose of this study was to identify whether there is a difference in time use by criteria (eight activity areas in total) and what factors influence the life satisfaction of those in the OB group. To this end, we confirmed the use type of living time of older adults targeting healthy elders over 65 years of age in the ROK by classifying them into the OB group and the OI group. Based on the results of this study, we may identify the relationship among occupation, old age, health, and life satisfaction, and establish a retirement planning model for future generations of older adults’ as well as older adults’ households. We expect that this study will have important implications as a basis for intervention regarding time use and as basic material for program development.