Social Support

Although sometimes used interchangeably with terms such as social integration, social networks, or social relationships, a narrower definition of social support is also common. In that narrower usage, social support refers to social interaction in which the actions of one party are intended to benefit another party. Thus, though social support may be seen as one aspect of other, broader terms, it is differentiated in part by its focus on the provider’s intentions and the potential benefits to the recipient.

No clear consensus exists regarding definitions of the other descriptors of social interaction, but, in general, the following distinctions are made. Social integration denotes the existence, quantity, and/or breadth of social ties. Synonyms are social connectedness and social embeddedness. A lack of social integration has been labeled social isolation. Social network refers to the entire structure of an individual’s social relationships and the connections among them. A network may be described in multiple ways, such as its homogeneity (similarity among members) or density (ties among all members). Social relationships and social ties are broad, general terms that refer to an individual’s connections to others.

While social integration, social isolation, and social networks primarily refer to the structure of an individual’s relationships, the concept of social support is used to denote possible functions of those relationships. Much of the research examining the association of social relationships to well-being has been limited to measures of social integration or isolation. In interpreting the usually positive effects of integration on well-being, some researchers have suggested that integration is, in part, a proxy for social support. Thus, it is necessary to discuss social integration and social isolation in conjunction with social support. Although social support specifically focuses on the positive side of social interaction, the other terms (integration, networks, and relationships) include consideration of the negative side of interaction (e.g., conflict or excessive demands). Research on the potential costs of social relationships is more limited and is not addressed here.

Measures of social integration capture information about the quantity and variety of social ties maintained by an individual. To assess quantity of ties, seniors may be asked how many people they interact with on a regular basis or how many people to whom they feel close ties. Variety of ties addresses how many different social roles an individual occupies, including spouse, parent, grandparent, sibling, friend, neighbor, employee, volunteer, church member, organization member, and others.

Possible functions of relationships are also identified in measures of social support. As noted, the provision of social support in a relationship refers to actions taken by one party to assist or benefit another party. Several aspects of the interaction may be of interest, including:

• • The type of support provided
• • The quantity, timing, and/or frequency of support provided
• • Whether the support was actually received or simply is perceived as available
• • The recipient’s satisfaction with the level of support provided or available
• • The relationship between the parties involved
• • Whether or not the support has been or will be reciprocated

The types of social support fall into five general categories. Instrumental support refers to tangible items, such as financial assistance, goods, or services. For example, a disabled older person may receive meals or help with housework. To quantify instrumental support, studies have collected data on the dollar value of money or goods transferred and on hours of time given in services during a given time period. A simpler approach is to ask whether or not the amount transferred within the time period exceeded a specific level (e.g., $200 in the past twelve months). Emotional support includes provision of love, caring, sympathy, and other positive feelings. Appraisal support includes feedback given to individuals to assist them in self-evaluation or in appraising a situation. Informational support refers to helpful advice, information, and suggestions. For example, a senior may ask a friend’s opinion regarding which doctor to see. Companionship support refers to the presence of others with whom to participate in meaningful or enjoyable activities. Companionship is considered to provide the individual with a sense of belonging to a group. Differentiating among the intangible types of support (emotional, appraisal, informational, and companionship) can be difficult, as can quantifying the level of support provided. Collection of information typically is limited to whether or not the specific type of support was provided during the specified time period and, perhaps, the frequency with which the support was provided.

Some researchers have suggested that the quantity of support received is less important to well-being than the individual’s perception that support is available if needed. This distinction between received and perceived support has proven valuable in clarifying how social relations influence well-being. Received support appears to be more important in the face of specific problems or stressors, whereas perceived support seems to be of ongoing benefit. Measures of perceived support include questions regarding whether or not the senior has someone in whom to confide, someone to provide emotional support, or someone to provide caregiving should the need arise.

The relationship between the support provider and recipient is also relevant, as suggested by some popular gerontological models. In 1979, Marjorie Cantor proposed the hierarchical compensatory model, in which older individuals exhibit a hierarchy of preferences regarding who should provide support. A spouse typically is the first choice, followed by adult children; other kin, friends, and neighbors; and, finally, formal service providers. Who actually provides support to an older person needing assistance depends upon the availability, proximity, and emotional closeness of individuals in the person’s network, as well as on cultural norms.

Another important determinant is the older person’s level and types of needs; the more disabled an older person is, the more likely he or she is to rely on formal providers, particularly for instrumental support. The task-specific model, developed by Eugene Litwak (1985), takes account of both the older individual’s specific needs and the characteristics of the potential helpers. The model posits that the group or person most likely to be preferred as a support provider will be the one best suited to manage the necessary tasks. The model matches tasks to providers according to the following structural dimensions: proximity, length of commitment, commonality of lifestyle, group size, sources of motivation, division of labor, and level of technical knowledge. Litwak and colleagues have argued that the hierarchical-compensatory model is simply a special case of the task-specific model.

The hierarchical-compensatory model and the task-specific model primarily focus on provision of instrumental support and emphasize the distinction between informal and formal care. Informal care is defined as unpaid assistance provided to needy seniors. Family, friends, and neighbors represent informal sources of care and often provide aid with such tasks as light housekeeping, food shopping, meal preparation, and transportation. Formal sources of care include a range of services, from Meals-on-Wheels to home health care visitors, from adult day care to nursing home care. The more disabled an older person becomes, the more likely he or she is to rely on formal care providers.

The convoy model of social relations, proposed by Robert L. Kahn and Toni C. Antonucci, offers a broader view of social ties in old age. This model also incorporates the notion of a hierarchy of relationships in personal networks, but it bases this hierarchy on emotional closeness. The convoy model uses a life-span perspective; thus the focus on convoys as opposed to networks. The concept of the convoy captures the dynamic aspects of social ties, taking account of qualitative changes at the level of the individual, the dyad, and the network, as well as changes in network membership. Cause-and-effect relations are also an important part of the model. Because relationships unfold over time, past interactions influence future interactions. For example, past receipt of emotional support from a friend will predispose an individual to assist that friend in the future. Reciprocity in relations is viewed as the ideal and is positively related to well-being.