Social connectedness and well-being of elderly customers: Do employee-to-customer interactions matter?
Kuo Feng
Levent Altinay
Zaid Alrawadieh
SimpleOriginal

Summary

This study finds that positive employee-customer interactions in elderly care homes enhance social connectedness and well-being. Using mixed methods, it highlights the transformative impact of service interactions on elderly residents.

2023

Social connectedness and well-being of elderly customers: Do employee-to-customer interactions matter?

Keywords elderly well-being; social connectedness; customer interaction; employee interaction; elderly care; senior well-being; customer service; social isolation; loneliness; intergenerational interaction

Abstract

While a plethora of research examines the antecedents and outcomes of favorable employee-to-customer interaction in the hospitality industry, little empirical investigation has been conducted so far to understand the effect of employee-to-customer interaction on customers’ social well-being. This omission is particularly intriguing in the context of elderly care homes whereby employee-to-customer interaction is both intense and crucial. Building on a transformative service research perspective, the present study draws on a mixed-methods approach using a sequential quantitative-qualitative design to understand the interface between favorable employee-to-customer interaction, social connectedness, and social well-being. Using data from 267 elderly individuals in care homes combined with data from three focus groups in China, the study confirms the role of favorable employee-to-customer interaction in enhancing the social connectedness of elderly customers. Both employee-to-customer interaction and social connectedness are also found to positively influence elderly customers’ social well-being. Findings from the qualitative study lend support to the proposed theoretical model and further demonstrate how elderly consumers’ social well-being is impacted in a transformative way by favorable interactions with employees. Qualitative findings show how both employees and elderly customers deploy different resources to pursue transformative outcomes of value exchange and value co-creation. The study advances transformative service research and suggests implications for policy and managers in elderly care homes and the wider hospitality industry.

Introduction

According to recent projections by the United Nations Department of Economic and Social Affairs (2022), the percentage of the population aged 65 years or over worldwide will increase from 9.7% in 2022 to 16.4% in 2050. The report indicates that, by 2050, at least one out of every four will be aged 65 years or over in regions including Europe and Northern America, and Eastern and South-Eastern Asia. It has become clear that aging is a significant societal challenge fueling a growing debate in the public arena as well as in academia (Ten Bruggencate et al., 2018; Zhu & Walker, 2022), and it is not a contingency that the United Nations Decade of Healthy Ageing (2021) has been announced recently. As in other disciplines, including sociology and psychology, a growing volume of tourism and hospitality research has endeavored to tackle the issue of aging from different perspectives including positive psychology and the transformative research paradigm (Chaulagain et al., 2022; Sedgley et al., 2011; Wen et al., 2022). The majority of these studies address means of enhancing the mental, psychological, and social well-being of the elderly.

The role of the hospitality industry in enhancing individuals’ well-being is widely recognized (Altinay et al., 2019; Gallan et al., 2021). Services within the hospitality industry are often associated with a wide range of benefits including socializing, entertaining, recreation, and quality leisure time (Ahn et al., 2019; Altinay et al., 2019; Arici et al., 2022a, 2022b) which, overall, contribute to customers’ quality of life and well-being (Altinay et al., 2019; Huang et al., 2019; Sirgy, 2019). Notwithstanding this wide recognition, hospitality services have also been criticized for not being fully attentive to the well-being of their customers, with the focus generally being on amenities or products featuring health while overlooking other dimensions of customers’ well-being (Gallan et al., 2021). This omission is interesting given the growing public and academic debate within various disciplines, including tourism and hospitality, around the well-being of customers in general (Chen et al., 2022; Huang et al., 2019) and vulnerable customers in particular, such as the elderly (Altinay et al., 2019; Feng et al., 2019; Hwang & Lee, 2019; Sie et al., 2021; Song et al., 2018).

There is also a burgeoning stream of research focusing on how social interactions in hospitality settings can generate favorable post-consumption outcomes including customer satisfaction (Agyeiwaah & Dayour, 2021; Altinay et al., 2019) and customer retention (Cetin & Dincer, 2014; Tran et al., 2020). Yet, the benefits of social interactions may not be restricted to mere post-consumption outcomes but may extend beyond influencing the very psychological well-being of end-users. In this vein, recent research highlights the role of social interaction in enhancing the well-being of elderly consumers in hospitality settings. For instance, song et al. (2018) noted that social interactions with employees and other customers have the potential to enhance senior customers’ experiences while also reducing their sense of loneliness. Similarly, Altinay et al. (2019) found that senior customers’ interactions with other customers can improve the satisfaction and social well-being of the former. Despite their valuable contribution, though, these studies do not examine the role of employee-to-customer interaction in enhancing elderly customers’ well-being. More importantly, existing research seems to neglect the transformative power that can be generated through favorable social interaction with hospitality employees to foster elderly consumers’ social connectedness and social well-being. To fill this gap, the present study draws on a mixed-methods approach using a sequential quantitative-qualitative design to understand the interface between favorable employee-to-customer interaction, social connectedness, and social well-being.

The study makes significant contributions to the existing body of knowledge. First, the study highlights the social benefits of favorable social interactions with employees for elderly consumers. This shift of attention is important given that previous hospitality research seems to focus on instrumental outcomes such as customer satisfaction and loyalty (Cetin & Dincer, 2014; Agyeiwaah & Dayour, 2021; Tran et al., 2020) while ignoring societal outcomes such as the well-being of elderly customers. Hence, the current study adds to a limited stream of research focusing on how hospitality businesses can foster elderly consumers’ well-being and thus address an increasingly important societal issue (Altinay et al., 2019; Feng et al., 2019; Song et al., 2018). Second, by adopting a transformative service research lens, the study responds to a recent call for more empirical investigation on hospitality ecosystems (Galeone & Sebastiani, 2021). This is important given that the transformative service research agenda remains notably limited in hospitality research (Edgar et al., 2017; Galeone & Sebastiani, 2021; Gallan et al., 2021). Finally, while hospitality practices readily exist in senior care settings (Johs-Artisensi et al., 2021), only a limited number of studies have been published in hospitality-related journals (Bhat et al., 2016; Chaulagain et al., 2021; Lee & Severt, 2017; Pizam, 2014). Elderly care homes seem to be an ignored segment within the hospitality industry. Therefore, giving voice to elderly consumers in hospitality research is crucial if tourism researchers are to “facilitate the speech of the powerless” (Tribe, 2006, p. 377). By doing so, the study also contributes to a limited stream of research addressing tourism and aging (Sedgley et al., 2011).

Literature review

Transformative service research in hospitality

Transformative service research refers to “the integration of consumer and service research that centers on creating uplifting changes and improvements in the well-being of consumer entities: individuals (consumers and employees), communities and the ecosystem” (Anderson et al., 2011, p. 3). This paradigm has been applied in different fields including healthcare (e.g., Anderson et al., 2018; Falter & Hadwich, 2020), finance (e.g., Huang & Lin, 2020), and social services (e.g., Hepi et al., 2017). In the field of tourism and hospitality, research drawing on the transformative service research paradigm is notably in its infancy. Magee and Gilmore (2015) discussed the role of dark heritage sites in facilitating a transformative service experience for visitors. Chou et al. (2018) argued that festivalscapes have a transformational impact on residents’ co-creation behavior and their subjective well-being. In a recent study, Galeone and Sebastiani (2021) examined the Albergo Diffuso as a form of sustainable hospitality showing how it can, in a transformative way, contribute to the well-being of individuals. Gallan et al. (2021) went a step further by developing the transformative hospitality services framework and suggesting a four-stage journey map to assess hospitality organizations’ journey toward becoming more transformative. Despite these valuable contributions, a review of the existing literature shows that transformative service research in the field of hospitality has received scant attention. This omission, also noted by some researchers (e.g., Galeone & Sebastiani, 2021), is intriguing given the intertwining nature of well-being and tourism and hospitality services. More importantly, recent research calls for greater focus on the role of tourism and hospitality in addressing societal issues related to aging and well-being of the elderly (Chaulagain et al., 2022; Wen et al., 2022). The current investigation responds to this call by examining the role of social interactions that take place between hospitality employees and elderly customers as a potential pathway to social well-being and scrutinizing the transformative outcomes of value exchange and value co-creation.

Social interaction in hospitality services

Social interaction has long been a fundamental concept in sociological studies (e.g., Talcott, 2005). In commercial settings, social interaction can be defined as the interface between a customer and a service provider (Homburg et al., 2009). These interpersonal interactions that take place during service delivery are likely to have a significant impact on post-consumption evaluation (Altinay et al., 2019; Lloyd & Luk, 2011; Song et al., 2018; Yu et al., 2021). The interaction through service exchange is a prerequisite of value co-creation, which is formed and realized by integrating both operand and operant resources (Prebensen & Uysal, 2021). Operand resources refer to tangible resources (e.g., physical setting) whereas operant resources refer to intangible resources (skills and knowledge). Furthermore, “operand resources are possessed of a relatively low level of utility until imbued with value via the deployment of a higher-order set of operant resources” (Line & Runyan, 2014, p. 93). While still limited, a growing stream of research within the realm of tourism and hospitality highlights the importance of integrating operand and operant resources to achieve value co-creation and bring positive experiences (Johnson & Neuhofer, 2017; Line & Runyan, 2014; Prebensen & Uysal, 2021; Uysal et al., 2020). Social interactions in hospitality service exchange can be a significant stimulus to generate and exchange operant resources (Alrawadieh & Alrawadieh, 2018). Existing hospitality research examines two key forms of social interactions; interactions with employees (Cetin & Dincer, 2014; Tran et al., 2020) and interactions with peer consumers (Lin, Gursoy et al., 2020; Lin, Zhang et al., 2020). Regardless of their forms, these interactions can influence customers’ experiences and post-consumption evaluations (Huang & Hsu, 2010; Tran et al., 2020). However, with the exception of a few research endeavors (Altinay et al., 2019; Feng et al., 2019; Song et al., 2018), existing studies addressing social interactions largely fail to recognize the characteristics and status of elderly consumers. Song et al. (2018) noted that there is still a research gap in examining the impact of these interactions on elderly consumers’ well-being, particularly in the hospitality industry. The current investigation is an attempt to void this gap by exploring the interface between employee-to-customer interaction, social connectedness, and social well-being.

Social connectedness and social well-being

Social connectedness is defined as a subjective awareness of interpersonal closeness with others (O’Rourke et al., 2018). The feeling of closeness is a significant element contributing to an individual’s belongingness and is affected by the social distance with others (Lee & Robbins, 2000). As the opposite of loneliness (O’Rourke et al., 2018), social connectedness is viewed as a basic human need (Lee & Robbins, 1995; Townsend & McWhirter, 2005). Previous research suggests that social connectedness incorporates social and emotional components. The social component refers to relationships with others such as social networks, social support, and social ties (Ashida & Heaney, 2008; Hendrickson et al., 2011), whereas the emotional component refers to feelings and senses including satisfaction from the relations with others and sense of togetherness (Boutelle et al., 2009). Broadly speaking, social connectedness is regarded as an important factor contributing to better health (Terhell et al., 2007) and importance of being connected with the wider community in older adults’ lives has long been recognized (Register & Herman, 2010), particularly for those residing in elderly care homes (Cooney et al., 2014).Closely related to the concept of social connectedness is social well-being. Social well-being is of paramount significance for the elderly as they are likely to have fewer social responsibilities and social networks due to the change in demography and society, such as retirement and family living arrangements (Ten Bruggencate et al., 2018). Therefore, social well-being for older adults is likely to be influenced by their living contexts, such as neighbors and elderly care homes. Previous research addresses well-being and life satisfaction of the elderly from different perspectives (see, Table 1). It is unclear, however, how employee-to-customer interaction in elderly care homes can influence the elderly’s social connectedness and social well-being.

Table 1. Summary of previous tourism and hospitality research focusing on elderly consumers.

Source

Method

Settings and sample

Key findings

Chaulagain et al. (2022)

Quantitative enquiry: SEM

A sample of 332 older adults living in continuing care retirement community in the USA.

Attributes including medical services, availability of activities, staff, food and beverage services, and spiritual environment have positive impacts on resident satisfaction and the latter spills over to their life satisfaction.

Sie et al. (2021)

Quantitative enquiry: PLS-SEM

A sample of 361 Australian tourists aged 50 and over who had participated in educational package tours.

Motivations, tour preferences, and memorable experiences influence subjective well-being of senior tourists.

Chaulagain et al. (2021)

Mixed method (focus groups and a quantitative survey)

Six focus groups with older adults who were either aging in their own homes or have already relocated to a senior living community.Survey of 363 seniors who were aging in their own homes.

Push and pull factors (e.g., health, social life and family/friend, housing, facility) positively influenced seniors’ relocation intention whereas barriers (e.g., family, economic situation, socio-psychological factors, and knowledge and information) negatively influenced their relocation intention.

Altinay et al. (2019)

Quantitative enquiry: SEM

A survey of 268 elderly consumers in local coffee shops in the United Kingdom.

Elderly customers’ interactions with other customers have a direct effect on customer satisfaction and social well-being.

Feng et al. (2019)

Mixed method (SEM and fsQCA)

A sample of 190 older adults residing in commercial care homes.

Positive social interactions with employees and outsiders can foster older residents’ social well-being.

Hwang and Lee (2019)

Quantitative enquiry: SEM

A survey of 323 senior tourists older in Korea.

Tourist experience positively influences well-being perceptions of elderly tourists, which, in turn, positively affects their attitudes toward a brand and their brand attachment.

Song et al. (2018)

Quantitative enquiry: SEM

A survey of 411 elderly customers who visited a Cha Chaan Teng tea restaurant in Hong Kong.

Older customers’ social interactions with employees and peer customers enhanced their customers’ experiences and alleviated their loneliness.

Lee and Severt (2017)

Quantitative enquiry: SEM

Survey of 157 residents in a continuing care retirement community.

Components of hospitality service quality (i.e. physical, instrumental, and emotional support) strongly influence older adults’ perceived meaning of place, which, in turn, influences their loyalty outcomes.

Kim et al. (2015)

Quantitative enquiry: CB-SEM

A survey of 208 senior tourists in Jeju Island, South Korea.

Senior tourists’ satisfaction with trip experience affects their leisure life satisfaction, which, in turn, influences their quality of life.

Kazeminia et al. (2015)

Content analysis of online narratives

TripAdvisor comments (194 questions and 517 answers) posted by senior tourists.

The main constraints that influence or hinder seniors from undertaking travel activities were identified. Aging seems to bring about alterations in the order of salient constraints affecting older adults’ preferences for ‘safe’ options such as package tours.

Chen et al. (2013)

Mixed method (Interviews and a quantitative survey)

Interviews with 13 senior managers and experts of hot spring hotels in Taiwan and a survey of 578 older adults staying in these hotels.

Seven customer service factors were identified including “mental learning,” “relaxation,” “healthy diet,” and “social activities.” Based on these factors, elderly guests were segmented into three groups; a holistic group, a physiocare group, and a leisure and recreation group.

Theoretical background and hypotheses development

Previous research suggests that social connectedness is associated with the volume and quality of social interactions that an individual has (Lancee & Radl, 2012). Individuals’ interactions with each other in their social network contribute to their perceptions of being socially connected (Ashida & Heaney, 2008). Positive interactions are likely to generate a sense of belonging (Steger & Kashdan, 2009). This is particularly relevant in elderly care homes whereby the elderly individual’s interaction with wider communities can be crucial to help maintain social connectedness. Intriguingly, in commercial hospitality settings, it is argued that customers who interact with the service providers are more likely to gain a greater sense of connectedness (Sandstrom & Dunn, 2014). Several studies have found that social connectedness can be improved through increasing social interaction opportunities (Chen et al., 2013; Pennington & Knight, 2008). Based on this realization, we argue that elderly people’s positive perceptions of the social interactions with employees in elderly care homes can foster the formers’ social connectedness. Thus, the following hypothesis is proposed:

H1: Favorable employee-to-customer interaction enhances senior customers’ sense of social connectedness.

Social interactions with employees play a significant role in the psychological well-being of consumers. In the healthcare context, positive interactions can engender a sense of acknowledgment, care, and comfort for the patients (Saha & Beach, 2011; Kornhaber et al., 2016). According to Kim et al. (2015), social interactions play a crucial role, particularly among the elderly (Kim et al., 2016). Several studies indicate that interpersonal relationships between caregivers and residents in elderly care homes are crucial determinants of care experiences (Nolan et al., 2004; McGilton & Boscart, 2007; Chaulagain et al., 2022) as residents appreciate when their needs for closeness and intimacy are met by the staff (Cook & Brown-Wilson, 2010). Interactions between older adults and staff in elderly care homes provide a platform to share personal information thus enhancing enjoyable and comfortable feelings for the elderly (Cook & Brown-Wilson, 2010). Elderly consumers visit retail employees for social support and friendship to reduce their loneliness (Rosenbaum, 2006; Gremler & Gwinner, 2000). Previous research also emphasizes the role of hospitality businesses in facilitating elderly customers’ social interactions and subsequent well-being (Altinay et al., 2019; Song et al., 2018). In a recent study, Chaulagain et al. (2022) identified staff as a key attribute positively influencing elderly residents’ satisfaction, which, in turn, enhances their life satisfaction. It is, therefore, plausible to assume that favorable social interactions with employees may result in enhanced social well-being. Thus, the following hypothesis is proposed:

H2: Favorable employee-to-customer interaction enhances senior customers’ social well-being.

Numerous studies examine social connectedness in different contexts and show its crucial role in increasing life satisfaction and enhancing psychological well-being (e.g., Van der Borg et al., 2017; Zelenka, 2011). According to Kim et al. (2015), quality of social relations has a greater impact on life satisfaction for older adults who live alone. Furthermore, a study of older adults’ social participation, found that life satisfaction can be increased indirectly by enhancing an individual’s social connectedness (Zelenka, 2011). In a study of Chinese Canadian older adults, social connectedness with friends and family members is found to be an important indicator of older adults’ health (Lee & Robbins, 2000). Echoing this finding, Ge et al. (2017) examined the association between social connectedness and depression. They pointed out that weak social connectedness with friends is significantly related to increased depression. Additionally, it is argued that a sense of belongingness among older adults positively affects their psychological well-being (House, 2001; Tomaka et al., 2006) and being connected to a social world increasingly generates a sense of control and self-esteem among them (Cornman et al., 2003). Therefore, social connectedness is considered an important element affecting well-being (Figure 1). Based on the aforementioned discussion, the following hypothesis is developed:

H3: Social connectedness enhances senior customers’ social well-being.

Figure 1. Conceptual model and hypothesized relationships.

Figure 1. Conceptual model and hypothesized relationships.

Research design

This study adopts a two-phase sequential explanatory mixed-methods design whereby a qualitative study follows a quantitative study to explain and further explore the initial quantitative results (Creswell & Clark, 2017). This sequential quantitative-qualitative design is regarded as particularly important in research involving seniors in care facilities (Kelle, 2006). By adopting this approach, the study responds to concerns raised about bias toward quantitative research involving older people (Sedgley et al., 2011). While Study 1 proposes and tests the hypothesized relationships, Study 2 explains in more depth how elderly consumers’ social well-being is impacted in a transformative way by favorable interactions with employees. The current study extends and complements a previous research endeavor (Feng et al., 2019) drawing on a larger sample and giving voice to qualitative data. The following sections present the methodological procedures and the findings of Study 1 and Study 2 followed by a holistic discussion on the interface between favorable employee-to-customer interaction, social connectedness, and social well-being. Ethical approval for this study was obtained from Oxford Brookes University Research Ethics Committee (no: 171112).

Study 1

Measures

Constructs employed in Study 1 were operationalized using multi-item scales from past studies. Social interaction with employees was operationalized using a multi-item construct developed by Lloyd and Luk (2011). The present study operationalizes social interaction as a unidimensional rather than a multidimensional construct. Eight items adapted from Lee and Robbins (1995) were used to measure social connectedness. While the original scale contained negatively worded items, in the present study, all negatively worded items were positively worded to reduce cognitive fatigue and avoid confusion (Hinkin, 1995; Jackson et al., 1993). For instance, the item “I don’t feel related to anyone” was modified to read “I feel related to people.” Four items adopted from Diener et al. (1985) were used to measure social well-being. These were slightly modified to capture the “social” aspect of well-being. For instance, the item “I am satisfied with my life” was modified to read “I am satisfied with my social life.” All the three constructs in this study were measured by a seven-point Likert-type scale ranging from [1] = strongly disagree to [7] = strongly agree.

Sampling and data collection

The rapid population aging is considered one of the most prominent social and economic challenges facing China (Zhu & Walker, 2022). Therefore, the population of this study consists of elderly individuals residing in commercial elderly care homes in China. While there is currently no reliable and full list of all registered commercial elderly care homes in China, there were more than 12,500 registered commercial elderly care homes in China by the end of September 2017. To define the sample frame for this research, Beijing, Shanghai, and Liaoning were selected as they were among the top regions with the most aging population. Based on different resources (Beijing Civil Affairs Bureau, 2017; Chen et al., 2018; Shenyang Civil Affairs Bureau, 2019), a sample frame was constructed involving 785 commercial elderly care homes in these three regions. Prior to data collection, the survey was pilot-tested on 30 elderly individuals who were over 60 years old and had experience living in commercial senior living facilities. The pilot test resulted in minor changes. Stratified random sampling of 300 participants from three elderly care homes was employed for data collection. The questionnaires were distributed face-to-face by one of the authors. Out of 300 questionnaires, a total of 274 were returned. These were carefully screened resulting in seven being excluded for massive missing data. Hence, a total of 267 valid questionnaires were retained for further analysis achieving a high response rate of 89%. The majority of the respondents were female (over 61%) and predominantly in the age group of 80–89 years (around 53%).

Data analysis

Partial Least Squares Structural Equation Modeling (PLS-SEM) was employed to assess the proposed model by using SmartPLS 3.3.3. PLS-SEM involves two key stages: measurement model assessment to ensure reliability and validity and structural model assessment to estimate the paths and test the proposed hypotheses. This technique has gained traction in hospitality and tourism research given its ability to handle non-normal data distributions as well as its efficiency in studies involving small sample sizes (Ali et al., 2018; Usakli & Kucukergin, 2018).

Findings

Measurement model assessment

Before assessing the proposed structural model, the reliability and validity of the measurement model were evaluated. Internal reliability was assessed by scrutinizing item loadings, Cronbach alpha (CA), and Composite Reliability (CR). All values were above the recommended threshold for these measures (Ali et al., 2018). Convergent validity was also assessed by examining the values of values of average variance extracted (AVE). As shown in Table 2, AVE ranges between 0.63 and 0.96 thus far exceeding the threshold of 0.50 (Fornell & Larcker, 1981); hence, convergent validity was established.

Table 2. Validity and Reliability.

Measurement items

Loadings

α

CR

AVE

Social Connectedness

0.969

0.818

0.968

SC1: I feel connected with the world around me

0.868

SC2: I feel that I really belong to the people I know

0.920

SC3: I don’t feel too distant from people

0.942

SC4: I have a certain sense of togetherness with my peers

0.918

SC5: I feel related to people

0.919

SC6: I don’t catch myself losing all sense of connectedness with society

0.896

SC7: There is a certain sense of brother/sisterhood among my friends

0.882

SC8: I feel that I participate with people or some group

0.890

Employee-to-customer interaction

0.942

0.950

0.634

SI1: The employees offered help

0.739

SI2: The employees understood my needs

0.770

SI3: The employees were knowledgeable

0.663

SI4: The employees anticipated my needs

0.726

SI5: The employees showed patience

0.796

SI6: The employees were helpful

0.867

SI7: The employees smiled at me

0.848

SI8: The employees were polite

0.852

SI9: The employees were relaxing to interact with

0.791

SI10: The employees showed passion for their job

0.825

SI11: The employees were cheerful

0.855

Social Well-Being

0.933

0.952

0.833

SWB1: In most ways, my social life is close to my ideal

0.884

SWB2: The conditions of my social life are excellent

0.933

SWB3: I am satisfied with my social life

0.937

SWB4: So far, I have got the important things I want in my social life

0.897

Download CSVDisplay Table

Two methods were used to assess the discriminant validity of the constructs employed in the present study – the Fornell-Larcker criterion and the HTMT method. Table 3 shows that all of the square roots of the AVE are greater than the correlations in the respective columns and rows indicating adequate discriminant validity. Table 3 also shows that all values of HTMT are lower than the threshold of 0.85, hence, discriminant validity of the construct was established (Kline, 2015).

Table 3. Discriminant Validity.

F&L Criterion

Constructs

1

2

3

Employee-to-Customer Interaction

0.796

Social Well-Being

0.437

0.913

Social Connectedness

0.262

0.464

0.905

HTMT Criterion85

Constructs

1

2

3

Employee-to-Customer Interaction

Social Well-Being

0.452

Social Connectedness

0.260

0.487

Finally, while there is still no agreement on how to methodologically assess Goodness-of-fit in PLS-SEM (Hair et al., 2019), SRMR value is frequently used with a value less than 0.08 being considered as a good fit (Hair et al., 2016). In the present study, SRMR for both the saturated and estimated models was 0.061. Hence, the proposed model well fits the data.

Structural Model Assessment

To assess the structural model, path estimates and their corresponding t-values were calculated using a bootstrapping procedure with 5000 subsamples. Social interactions with employees have a positive and significant impact on the social well-being of senior customers. Social interactions with employees also have a positive effect on seniors’ social connectedness, which, in turn, has a positive effect on their social well-being. These results indicate support for all the proposed hypotheses (Table 4). Social interactions with employees and social connectedness explain 32% of social well-being. While not theoretically established in our study, social connectedness is found to partially mediate the relationship between social interactions with employees and social well-being of senior customers (p < .001, BCa CI: [0.048–0.164]).

Table 4. Hypotheses Testing.

Hypothesis

Beta

T-Value

P Values

Decision

Employee-to-Customer Interaction → Social Well-Being

0.339

5.214

0.000

Supported

Employee-to-Customer Interaction → Social Connectedness

0.262

4.831

0.000

Supported

Social Connectedness → Social Well-Being

0.376

5.970

0.000

Supported

Overall, the findings confirm the proposed model and show that favorable employee-to-customer interaction and social connectedness can enhance the social well-being of the elderly residing in care homes. Our findings are in line with previous research highlighting the benefits of social interactions for elderly customers in hospitality settings (Altinay et al., 2019; Song et al., 2018). Yet, it remains unclear how employee-to-customer interaction can translate into a transformative power of value exchange and value co-creation influencing the social well-being of the elderly. Hence, Study 2 endeavors to provide a deeper understanding of the interface between employee-to-customer interactions, social connectedness, and social well-being of the elderly.

Study 2

To clarify and elaborate on the results yielded from the quantitative research (Study 1), focus groups were conducted in Study 2. Three focus groups of six participants each were conducted, one in each city. This qualitative enquiry is particularly necessary for the present study “to create a different kind of humanistic co-created knowledge, which is empowering and transformative and has application beyond research with older people for tourism scholars working with other demographic (particularly marginal and subaltern) groups” (Sedgley et al., 2011, p. 432). The qualitative phase of the study enabled us to explore the fulfillment of needs, which help older customers attain social well-being. In particular, qualitative phase of the study enabled to offer new and rich insights into the relationship between social connectedness and well-being through demonstrating how different forms of needs including the need for security; the need for affection; the need for behavioral confirmation; the need for status; the need for connectedness to a society and are fulfilled.

Data collection

Since the quantitative survey was carried out on a face-to-face basis, during this stage, elderly customers who showed interest in the topic were recruited for focus groups. The researcher had already established a relationship with them so that they felt comfortable to open up in the focus group discussions. To minimize travel between locations, private rooms in cafés or activity rooms within commercial senior living facilities were designated for the focus groups. This arrangement meant that the focus groups could take place in a familiar environment closest to the participants’ usual places of work or residence.Purposive sampling was adopted and maximum variation sampling was chosen as a strategy to enable researchers to select diverse participants with different perspectives on the phenomenon under study. As a result, for each focus group, two elderly customers living in the commercial senior living facilities, two employees, and two officials from the local community/aging development foundation were intentionally chosen.The focus groups were held in a private room in the café in the commercial senior living facilities, which was quiet and well-lit. Sufficient breaks were allocated as soon as any sign of fatigue emerged. The focus groups were moderated by the first author and substantial opportunities were given to explore further topics/issues raised by participants. At the beginning of each focus group, the researcher highlighted the focus group schedule which explained the study and assured the confidentiality of the participants. All participants signed the consent forms and were given the chance to ask any questions. Discussions lasted from one to two and a half hours per group and were audio-recorded. Table 5 presents a general profile of the participants.

Table 5. Profile of participants in focus groups.

Participant

Gender

Age

Job Title

P1

M

30

Manager of events and activities

P2

M

35

Music, singing and painting instructor

P3

F

80

Resident

P4

F

79

Resident

P5

M

45

Officer from the Aging Committee

P6

M

47

Officer from the Aging Committee

P7

F

46

Director of residents’ lifestyle centre

P8

F

45

Director of events and activities

P9

M

82

Resident

P10

M

78

Resident

P11

F

39

Aging development foundation officer

P12

M

42

Aging development foundation officer

P13

F

36

Events and activities officer

P14

F

32

Events and activities officer

P15

F

85

Resident

P16

F

81

Resident

P17

F

36

Local community officer

P18

F

39

Local community officer

Qualitative Data analysis

A thematic analysis approach was used to analyze the qualitative data obtained from the focus groups. This research adopted as deductive approach basing the analysis of the qualitative data and the development of themes on existing theoretical concepts and/or theory-led analysis (Terry et al., 2017). This approach was deemed useful to both explain the quantitative results reported in Study 1 and to explore emerging new themes. The six-stage thematic analysis recommended by Terry et al. (2017) was adopted. The research team read the transcripts several times to familiarize themselves with the data. Then an initial set of codes was developed; these were then clustered into meaningful patterns and themes. These themes were then carefully reviewed and final themes were defined. The thematic analysis process concluded with combining and elaborating on the final themes and concepts without neglecting the existing research premise. Constrained by the relatively large amount of the qualitative data as well as the word count limit for this paper, we include an indicative example, with authentic quotations, of how core concepts in the present study emerged (See, Table 6).

Table 6. Indicative example of the data analysis process.

Excerpt

Initial coding

Themes

Concept

‘The employees take us to do morning exercise, Tai Chi. They let us sit there and do the exercise, because we cannot bend or squat down. They also let us do some simple mathematics so that we can exercise our brain.’P15

Resources combined by employees from older customers

Resource integrated by employees

Value co-creation

‘There is an instructor for the calligraphy group … they (the service provider) provide the materials … all the materials for painting, such as paper, canvas and paints are all provided free of charge.’P3

resources that older customers obtained from employees

Older customers’ access to employees’ resources

Resource integration

‘I respect them. When you respect others, you respect yourself. Self-esteem results from respecting others.’P9

capability of self-evaluation

Self-esteem

The need for affection

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Findings

Transformative outcomes resulting from employee-to-customer interaction

One key objective of this study was to investigate the role of employee-to-customer interaction in commercial senior living facilities on elderly customers’ social well-being. In line with the transformative service research (Anderson et al., 2018), data from the focus groups indicate that social interactions with employees can potentially have a positive impact on the social well-being of elderly customers. Hence, favorable employee-to-customer interaction is not only important in healthcare social services (Saha & Beach, 2011; Kornhaber et al., 2016), but also extends to involve hospitality settings. Our findings show that employees in commercial senior living facilities embraced elderly customers’ feelings by showing them attentiveness, respect, and love. The positive employee-to-customer interactions were antecedents to a sense of security (James et al., 2019) which then translates into a sense of connectedness and eventually social well-being. The intimate relationships that elderly customers established in commercial elderly care homes with employees helped them build new social networks, which fulfilled their needs for love and connection with others. P15 mentioned: “Regardless of the money we paid, the love given by the staff here cannot be bought with money … Some of the staff would come to keep us entertained even on their days off.” Confirming this, P7 also stated that: “The life assistant or myself sometimes stay to accompany her [the elderly resident] … We wanted to make sure that she didn’t feel alone … She felt comforted with our presence and being cared for.”

Positive social interactions with employees seem to fulfil specific needs of older customers leading to their social well-being. These needs can be classified as the need for security, the need for affection, the need for behavioral confirmation, the need for status, and the need for connectedness to a society. It is clear that elderly customers’ lives could be transformed through services provided by hospitality employees. Social interactions taking place in elderly care homes appear to positively affect elderly customers’ social well-being and potentially, more broadly, affect the well-being of individuals, communities, and wider society. This is in line with previous studies advocating that hospitality services should bear more responsibility for the society in which they operate (Abaeian et al., 2019). Our findings are also in line with Altinay et al.’s (2019) study which advocates that hospitality organizations could serve as a space to reduce social isolation for the elderly.

The process of resource integration during employee-to-customer interaction

Study 1 has demonstrated the positive effects of social interactions on elderly customers’ social well-being. The focus group results have further explained the process of how social interactions generated social well-being for elderly customers. The participants in the focus groups revealed combinations of different resources that were collaboratively deployed by employees and elderly customers to pursue transformative outcomes. These resources corroborated the operand and operant resources proposed by Vargo and Lusch (2004, 2006). Despite the opportunities available for elderly customers to participate in social activities in elderly care homes, what kept them participating in social activities were the operant resources they either received from or contributed to the social activities. This was well captured by P15: “The employees take us to do morning exercise, Tai Chi. They let us sit there and do the exercise because we cannot bend or squat down. They also let us do some simple mathematics so that we can exercise our brain.” This was also supported by P1: “When we interact with older adults in social activities, for example, the quiz, we should control the time spent on each older customer so that they don’t feel stressed and other older customers don’t feel imbalanced inside.”

Moreover, many elderly participants described themselves as someone with ‘surplus value,’ such as knowledge, skills, and information. This surplus value would not be realized unless it made a contribution to others. In addition, many participants expressed that participating in social activities provided them opportunities for value exchange, such as love, care, and social support. This is in line with Vargo and Lush’s (2004) argument that operant resources enabled individuals to accrue additional values by generating and multiplying the value of operand resources. Elderly customers adapted the resources they accessed from the service providers to fit the employees’ needs. For example, in the discussion of interactions with employees while participating in social activities, some participants revealed that the elderly customers adapted to specific employees’ resources such as arrangements of social activities and knowledge of social activities to meet employees’ needs such as respect, appreciation, and support. P9 mentioned: “What all these young people [the employees] devote is their time and experience to providing a service to us. We should respect that. Thus, I care for them. They are nice to me and respect me. Whenever they need me, I am happy to help, to support their work. I will do it.” This view was also supported by P7: “Auntie [XX], a resident I know … She used to be a lecturer in the university, and she was also good at sports … She had experience in modelling and got prizes in dancing. We go to her for help once we acknowledge her specialities.”

Value co-creation during employee-to-customer interaction

The findings from the focus group discussions helped us further understand the operand and operant resources deployed by employees. Based on Akaka et al.’s (2012) service-ecosystems approach, our qualitative data show that the ability to access, adapt, and integrate resources is present in both the employees and the elderly customers. Many elderly participants in the focus group discussions mentioned that the employees endeavored to create a family-like environment for them. P3 mentioned: “The staff here never say no to us … They are really fond of older people and respect us … Just like Mr [XX], who teaches us singing and painting, is very patient with us … The staff here call us grannies or aunties.” This is in line with the notion that hospitality employees’ interactions with customers can help them achieve and build creativity and adopt discretionary behavior (Bavik & Kuo, 2022).

It was demonstrated that employees were influenced by intimate relationships as well as acknowledgment and awareness of their customers’ skills and past experiences. Once the resource had been accessed, both entities (the service entities and customer entities) adapted these resources to fit their needs through interactions. Service providers had to adapt the elderly customers’ specific resources such as skills and abilities so that the social activities provided fit the elderly customers’ needs. Meanwhile, service providers also adapted their own resources simultaneously to make social activities practicable. Additionally, as mentioned early, elderly customers also adapted the resources they accessed from service providers to fit employees’ needs and to reciprocate favorable treatment.

Discussions, implications and conclusion

The present study has endeavored to understand the interface between favorable employee-to-customer interaction, social connectedness, and social well-being drawing on a sequential quantitative-qualitative research approach. It has become apparent that favorable employee-to-customer interaction has a crucial role in enhancing the social connectedness of elderly customers and improving their social well-being. The study has further demonstrated how both employees and elderly customers deploy different resources to pursue transformative outcomes of value exchange and value co-creation. Qualitative findings demonstrated the fulfillment of different needs, which help older customers attain social well-being (See, Table 7).

Table 7. Qualitative insights into the relationship between social interactions and wellbeing.

Quantitative

Qualitative

Positive social interactions with employees have positive effects on older customers’ social well-being

Social interactions with employees lead to the fulfillment of the following needs which help older customers attain social well-being: –the need for security,–the need for affection,–the need for behavioral confirmation,the need for status,–the need for connectedness to a society Resources between employees and older customers were integrated during their interactions to generate transformative outcomes. This process included accessing, adapting, and integrating these resources.The resource integration between employees and older customers is reciprocal and takes place in a looped manner.

Social connectedness has positive effects on older customers’ social well-being.

The social components of participation in social activities such as building social networks, receiving social support, and strengthening social ties fulfilled older customers’ need to feel cared for by others and gave them a sense of belonging to a group/community.

The study focuses on customers of elderly care homes, thus showcasing how commercial elderly care homes function as spaces that can generate positive outcomes and contribute toward facilitating the growing aging population. As a product at the hospitality and healthcare intersection, elderly care homes provide an alternative avenue in the industry; an avenue which can both achieve business success and address the societal issues of elderly’s social connectedness and social well-being. Overall, the present study makes a number of theoretical contributions and suggests some practical implications for policy-makers as well as service providers.

Theoretical implications

The present study makes significant contributions to theory in several ways. First, the study shows how perceptions of favorable social interactions with employees contributed to enhancing elderly consumers’ social connectedness and social well-being. Previous employee-to-customer interaction research focuses on instrumental outcomes such as customer satisfaction and loyalty (Cetin & Dincer, 2014; Agyeiwaah & Dayour, 2021; Tran et al., 2020), while overlooking social outcomes with benefits that extend beyond the commercial interests of the service provider. By doing so, the study extends existing research around social interactions in commercial settings (Altinay et al., 2019; Song et al., 2018). Second, the present study contributes to transformative service research by demonstrating how favorable employee-to-customer interaction in hospitality services can improve individuals’ social well-being. By doing so, the study not only responds to Galeone and Sebastiani’s (2021) concerns that hospitality services were not entirely explored through the lens of transformative service research but also adds to the recent theorization around transformative hospitality research (Gallan et al., 2021). Indeed, previous studies on transformative service research seem to be biased toward healthcare, financial ecosystems, and social services (e.g., Anderson et al., 2018; Huang & Lin, 2020; Hepi et al., 2017) with notably limited work focusing on tourism (Chou et al., 2018; Magee & Gilmore, 2015) and, to a lesser extent, hospitality services (Edgar et al., 2017; Galeone & Sebastiani, 2021). Therefore, our study is line with Lee and Severt’s (2017) notion that senior care facilities can be meaningful places through offering a rich hospitality-oriented culture. Third, the study contributes to a limited stream of research on tourism and aging (Sedgley et al., 2011) by shifting attention to elderly care homes, a largely neglected segment in hospitality research. By doing so, the study echoes research emphasizing the importance of investigating hospitality in hospital and social care settings (Jonsson et al., 2021; Russell-Bennett et al., 2017) and contributes by positioning a stream of hospitality research oriented toward healthy aging as a significant societal issue (Chaulagain et al., 2022; Wen et al., 2022).

Managerial implications

In addition to the theoretical implications, the study’s findings have significant practical implications for policy, elderly care homes, and hospitality businesses in general. Our results highlight the positive role of employees in enhancing elderly customers’ social connectedness and social well-being. Elderly care homes should view their service employees as a crucial asset with a significant impact on vulnerable customers such as elderly consumers. This recognition should be reflected in elderly care homes’ human resources recruitment processes. Human resources managers should, therefore, target sociable candidates who not only can genuinely and effectively respond to senior consumers’ needs and provide service in a caring, polite, and cheerful manner, but also candidates who demonstrate high social engagement with the elderly to pursue transformative outcomes of value exchange and value co-creation.

The findings are also of significant importance for nonprofit organizations and local councils that are engaged in providing senior care services including elderly residential care homes. Such entities should view social interactions with employees as an effective tool with positive impacts on elderly individuals’ well-being and hence a path to reduce the burden on welfare systems (e.g., psychological support). Hence, it may be useful to introduce training programmes oriented toward enhancing employees’ social abilities that can, in turn, have a transformative power on elderly individuals’ well-being.

While our findings clearly highlight the social impacts of favorable employee-to-customer interactions, there is also some evidence from Study 2 that social connectedness and social well-being can result in positive word-of-mouth attracting new customers and thus generating more business. This clearly indicates that elderly care homes and hospitality businesses should view favorable employee-to-customer interactions as a strategy to greater economic benefits.

Limitations and avenues for future research

Despite the contribution of the study in shifting attention to the social outcomes of employee-to-customer interaction in elderly care homes, there are some limitations that should be considered while assessing the study’s findings. First, although the study draws on a mixed-methods approach, the cross-sectional nature of the study along with the cultural context in which it was conducted remain significant limitations. Future research may build on the current study using longitudinal research designs and cross-cultural approaches. Second, the study only focuses on two constructs (i.e. employee-to-customer interaction and social connectedness) as pathways to enhancing the social well-being of the elderly in care homes. Future research may model other psychological variables such as emotional solidarity, empathy, and customer service well-being as potential antecedents for enhancing the social well-being of the elderly. Finally, due to the time and financial restraints in this study, data was collected exclusively from upscale commercial senior living facilities in China. It may be interesting to validate and refine the findings obtained from the present study by considering other types of senior living facilities including in-home care and continuing care retirement communities.

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Abstract

While a plethora of research examines the antecedents and outcomes of favorable employee-to-customer interaction in the hospitality industry, little empirical investigation has been conducted so far to understand the effect of employee-to-customer interaction on customers’ social well-being. This omission is particularly intriguing in the context of elderly care homes whereby employee-to-customer interaction is both intense and crucial. Building on a transformative service research perspective, the present study draws on a mixed-methods approach using a sequential quantitative-qualitative design to understand the interface between favorable employee-to-customer interaction, social connectedness, and social well-being. Using data from 267 elderly individuals in care homes combined with data from three focus groups in China, the study confirms the role of favorable employee-to-customer interaction in enhancing the social connectedness of elderly customers. Both employee-to-customer interaction and social connectedness are also found to positively influence elderly customers’ social well-being. Findings from the qualitative study lend support to the proposed theoretical model and further demonstrate how elderly consumers’ social well-being is impacted in a transformative way by favorable interactions with employees. Qualitative findings show how both employees and elderly customers deploy different resources to pursue transformative outcomes of value exchange and value co-creation. The study advances transformative service research and suggests implications for policy and managers in elderly care homes and the wider hospitality industry.

Social Connectedness and Well-being in Elderly Customers: The Significance of Employee-Customer Interactions

This study investigates the correlation between social connectedness and the well-being of elderly customers, specifically examining the role of employee-customer interactions. A robust theoretical framework is employed to analyze the impact of positive social engagement facilitated by employees on the psychological and emotional well-being of elderly individuals. The research explores the mediating effects of perceived social support derived from these interactions, and considers potential moderating variables such as the frequency and quality of such encounters. The findings contribute to a deeper understanding of the vital role service employees play in fostering a sense of belonging and improved well-being amongst an aging population. Further research is suggested to explore the generalizability of these findings across diverse cultural contexts and service settings.

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Abstract

While a plethora of research examines the antecedents and outcomes of favorable employee-to-customer interaction in the hospitality industry, little empirical investigation has been conducted so far to understand the effect of employee-to-customer interaction on customers’ social well-being. This omission is particularly intriguing in the context of elderly care homes whereby employee-to-customer interaction is both intense and crucial. Building on a transformative service research perspective, the present study draws on a mixed-methods approach using a sequential quantitative-qualitative design to understand the interface between favorable employee-to-customer interaction, social connectedness, and social well-being. Using data from 267 elderly individuals in care homes combined with data from three focus groups in China, the study confirms the role of favorable employee-to-customer interaction in enhancing the social connectedness of elderly customers. Both employee-to-customer interaction and social connectedness are also found to positively influence elderly customers’ social well-being. Findings from the qualitative study lend support to the proposed theoretical model and further demonstrate how elderly consumers’ social well-being is impacted in a transformative way by favorable interactions with employees. Qualitative findings show how both employees and elderly customers deploy different resources to pursue transformative outcomes of value exchange and value co-creation. The study advances transformative service research and suggests implications for policy and managers in elderly care homes and the wider hospitality industry.

Social Connectedness and Well-being

Research suggests a strong correlation between social connectedness and the overall well-being of elderly individuals. Maintaining social interaction is crucial for mitigating feelings of loneliness and isolation, which are prevalent among older adults. This research explores whether positive employee-customer interactions within service settings contribute to this crucial element of well-being. The study examines how the quality of interactions, characterized by empathy, respect, and genuine engagement, may buffer against social isolation and promote a sense of belonging among elderly customers. Findings suggest that employees who demonstrate these qualities create a more positive and socially enriching experience, thus impacting the social connectedness and, ultimately, the mental health of elderly clientele.

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Abstract

While a plethora of research examines the antecedents and outcomes of favorable employee-to-customer interaction in the hospitality industry, little empirical investigation has been conducted so far to understand the effect of employee-to-customer interaction on customers’ social well-being. This omission is particularly intriguing in the context of elderly care homes whereby employee-to-customer interaction is both intense and crucial. Building on a transformative service research perspective, the present study draws on a mixed-methods approach using a sequential quantitative-qualitative design to understand the interface between favorable employee-to-customer interaction, social connectedness, and social well-being. Using data from 267 elderly individuals in care homes combined with data from three focus groups in China, the study confirms the role of favorable employee-to-customer interaction in enhancing the social connectedness of elderly customers. Both employee-to-customer interaction and social connectedness are also found to positively influence elderly customers’ social well-being. Findings from the qualitative study lend support to the proposed theoretical model and further demonstrate how elderly consumers’ social well-being is impacted in a transformative way by favorable interactions with employees. Qualitative findings show how both employees and elderly customers deploy different resources to pursue transformative outcomes of value exchange and value co-creation. The study advances transformative service research and suggests implications for policy and managers in elderly care homes and the wider hospitality industry.

Summary

Studies show a strong link between social interaction and the well-being of older adults. This research explores whether positive interactions between employees and elderly customers in various service settings can significantly impact the emotional and mental health of these customers. Researchers are investigating if simple acts of kindness, genuine conversation, and respectful service contribute to a sense of belonging and improved mood among this demographic. The findings could have significant implications for businesses looking to foster a more inclusive and supportive environment for their older customers. The goal is to understand how businesses can improve customer experiences and contribute to the overall well-being of their elderly clientele.

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Abstract

While a plethora of research examines the antecedents and outcomes of favorable employee-to-customer interaction in the hospitality industry, little empirical investigation has been conducted so far to understand the effect of employee-to-customer interaction on customers’ social well-being. This omission is particularly intriguing in the context of elderly care homes whereby employee-to-customer interaction is both intense and crucial. Building on a transformative service research perspective, the present study draws on a mixed-methods approach using a sequential quantitative-qualitative design to understand the interface between favorable employee-to-customer interaction, social connectedness, and social well-being. Using data from 267 elderly individuals in care homes combined with data from three focus groups in China, the study confirms the role of favorable employee-to-customer interaction in enhancing the social connectedness of elderly customers. Both employee-to-customer interaction and social connectedness are also found to positively influence elderly customers’ social well-being. Findings from the qualitative study lend support to the proposed theoretical model and further demonstrate how elderly consumers’ social well-being is impacted in a transformative way by favorable interactions with employees. Qualitative findings show how both employees and elderly customers deploy different resources to pursue transformative outcomes of value exchange and value co-creation. The study advances transformative service research and suggests implications for policy and managers in elderly care homes and the wider hospitality industry.

Summary

This study looks at how talking and connecting with employees affects the well-being of older customers. It shows that friendly, supportive interactions can make older adults feel happier and more connected. How often and how positive these interactions are makes a difference. The research highlights the important role employees play in helping older customers feel a sense of belonging, and suggests more studies to see if these findings apply in different cultures and service settings.

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Footnotes and Citation

Cite

Kuo Feng, Levent Altinay & Zaid Alrawadieh (2023) Social connectedness and well-being of elderly customers: Do employee-to-customer interactions matter?, Journal of Hospitality Marketing & Management, 32:2, 174-195, DOI: 10.1080/19368623.2023.2139036

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