Social problems among Elderly people at Geriatric homes in the Middle Euphrates Governorates

 

Waseem A. Shakir¹, Saja H. Mohammed²

¹MSC N, College of Nursing, University of Babylon

²Prof. Psychiatric and Mental Health Nursing Department, College of Nursing, University of Babylon

 

ABSTRACT:

Background: Social isolation is the absence of relationships with family of friends on an person level, and with society on a broader level, especially the elderly who suffering from health or psychological illness which may lead to early death.

Objective: To assess the social problems among elderly people at geriatric homes in the Middle Euphrates Governorates.

Methodology: A descriptive correlation analytical study included a purposive (non –probability) sample of (82) elderly was selected for the present study. The data had been collection from 17th February 2016 to 3rd April 2016. Data were collected through the use of the constructed questionnaire and the process of interviewing to elderly people. Data were analyzed through the application of descriptive statistical analysis (percentage, frequency and inferential data analysis) (Chi-square) with (SPSS, Version 20).

Results: The findings of the study indicate that most of the samples (45.1%) have moderate social isolation level, (36.6 %) have severe social isolation level and (18.3%) of the samples has mild social isolation. There is a high significant relationship in social isolation level with socio-demographic data (age, age at admission, residence years in geriatric homes, previous professions, educational level, social status, and economic status), there was a significant relationship in social isolation level with socio-demographic data (gender, financial support by family, financial resources).

Conclusion: All elderly people affected with the social problems in different levels and no significant relationship between financial support by family and financial sources and between males and females in a changing sex with social problems.

Recommendations: The studies recommend to promotion, social support programs for elderly people and provide all possible means of support.

 

 

 

 

INTRODUCTION:

Elderly or old age consists of ages nearing or surpassing the average life span of human beings. The boundary of old age cannot be defined exactly because it does not have the same meaning in all societies ⁽¹⁾. Ageing is an inevitable developmental phenomenon bringing along a number of changes in a physical, psychological, hormonal and the social conditions.

 

Define ageing in terms of the biology, referring to ‘‘the regular changes that occur in mature genetically representative organism living under reprehensive environmental conditions as they advance in chronological age’’. Old age has been viewed, as problematic period of one's life. The old person's age become increasingly dependent on others ⁽²⁾. The world's population is ageing rapidly Between  2015 and 2050, the population of the world's order adult is estimated to almost double  from about 12% to 22% In absolute terms, this is an expected increase from 900 million to 2 billion people over the age of 60 ⁽³⁾. The big shift towards in aging population is due to delayed effect of high fertility levels after the Second World War and further new improvements in health care which lead to decrease in death averages at advanced ages ⁽⁴⁾. Elderly people resisted private physical and mental health challenges that should be an acknowledged ⁽³⁾.

 

Loss of a spouse takes a heavy toll on health and is one of the primary causes of depression. Being left alone often prevents many older persons from enjoying life. Retirement and interpersonal difficulties with family members, poverty and loneliness. Use of multiple medicines, retirements, financial crisis, fear of death ⁽²⁾. These situations greatly impact the psychological statuses of the elderly, making them prone to depression⁽⁵⁾. In addition to physical problems, mental conditions are common in nursing home residents. In fact, dementia remains the most common problem, and affects in an estimated 50-70% of residents. More than three fourths of nursing-home residents have problems making daily decisions, and two thirds have problems with memory or knowing where they are from time to time ⁽⁶⁾.

 

Geriatric homes are licensed health care facilities that are inspected and regulated by a state’s Department of Health Services. They offer long- and short-term care for individuals who need rehabilitation services or who suffer from serious or persistent health issues, such as Alzheimer’s disease, that are too complicated to be tended to at home or at an assisted in living facility⁽⁷⁾. The world's population has been experiencing significant ageing which that results in rising proportions of older persons in the total population- since the mid-twentieth century. Ageing has started earlier in the more developed regions and was beginning to take place in some developing countries ⁽⁸⁾.

 

Important alterations in the life that take place as we get advance in age may cause sensations of uneasiness, stress and unhappiness. For example, the dying of one of the family, transform from function into pension, or treated with a dangerous disease can left people sensation sad or concern⁽⁹⁾. Various studies have been conducted to analyze the health and related issues associated with old age, which needs further exploration, so the present study was focused on various socio-demographic profile and its association with Psycho-social problems⁽¹⁾.

 

OBJECTIVES OF THE STUDY:

1. To assess the social problems among elderly people at geriatric homes.

2. To find out the relationship between the social problems of elderly people with their demographical data such as (age, age at admission, residence years in geriatric homes, previous professions, educational level, social status, economic status, financial support by family, the financial resources).

 

METHODOLOGY:

A descriptive analytical study using the technique of assessment to assess the psychosocial problems among elderly people at geriatric homes in the Middle Euphrates Governorates. The study was carried out to assess the social problems among elderly people which are (social isolation).

 

To achieve the purpose of the study. A questionnaire was constructed by the researcher.

The questionnaire items based on:

·        Extensive review of related studies and literature.

·        Scales such as: Loneliness Scale.

 

The questionnaire consists of social problems which contain 12 items concerned with the social isolation.

 

In order to test the validity of the questionnaires, the instrument was presented to panel of experts in different fields to make it more valid.

 

The data collection was carried out from February 17th 2016 to April 3rd 2016. The questionnaire has been administrated personally by the researcher to elderly people. Data were analyzed through the application of descriptive statistical analysis (Frequency F., Percentage P.) and inferential data analysis plan (Chi-square) with (SPSS, Version 20).

 

RESULTS:

Table (1) shows that the majority (43.9%) of elderly sample within the age group (65-74) years, regarding to their age at admission (47.6 %) their age (65-74) years. Regarding their residence years in geriatric homes (65.9 %) of the sample their residence years in geriatric homes (1-4 years). According to gender the majority of the sample (59.8%) were male and (40.2%) were female, In regards to previous professions (32.9%) is retired, (32.9%) free business, (34.1%) housewife. The table shows also educational level (42.7%) of the sample were illiterates, (32.9%) primary school graduate. Also the table shows social status (24.4%) single, (26.8%) married, (29.3%) divorced.

 

Regarding to economic status (43.9%) have  pension, (56.1%) have salary from the social welfare, As regards to financial support by family (89.0%) they have no supported from their family, (11.0%) they have supported from their family, In regards to the financial resources (47.6%) of the sample their financial resources not enough while (14.6%) semi-enough, (37.8%) enough. Table (2) indicates that the majority of the samples (45.1%) have moderate social isolation level, (36.6 % (have severe social isolation level and (18.3%) of the samples have mild social isolation level.

 

This table indicates that there is a high significant relationship between social isolation levels with socio-demographic data (age, age at admission, residence years in geriatric homes, previous professions, educational level, social status, economic status) at the subject according to account chi-square value and expected value (3.714 < 0.91, 4.274 < 1.65, 9.351 < 1.28, 12.668 < 4.94, 12.184 < 1.46, 6.735 < 0.55, 12.117 < 6.59) respectively that indicate the relationship is acceptable, this table indicates that there is a significant relationship between social isolation levels with socio-demographic data (gender, financial support by family, the financial resources) at the subject according to account chi-square value and expected value (7.162 = 6.04, 1.591 = 1.65, 2.963 = 2.20) respectively that indicate the relationship is equal.

 

DISCUSSION:

The findings of the study shows that the majority of the sample (43.9%) were in the age group (75-84) years. This mean that is the age group who need to be in geriatric homes when there is no one give care to them. This result is supported by (10) who found that (41.4%) were in the age group (75-84) years ⁽¹⁰⁾, while (11)who found that (46.6% and 57%) of his family sample were at age group (60-70) years.⁽¹¹⁾.

 

According to the age at admission to geriatric home the result indicates that most of sample (47.6%) were in the age group (65-74) years. This means that a large proportion of elderly in the Middle Euphrates governorates they entering geriatric homes in this age groups from their lives because most of the elderly were suffering from losing their abilities and motor skills and they need someone to give care. This result were supported by (12) who found that (65.6%) were in the aged group (65-74) years⁽¹²⁾.

 

Regarding to the residence years in geriatric homes the most of the sample (65.9%) their residence years in  geriatric homes were (1-4) years. This result is supported by (13) who found that the elderly people residents in the geriatric homes (66%) between (1-5) years⁽¹³⁾.

 

Concerning with the gender the present study show that the most of the sample (59.8%) were male, (40.2%) were female. This means the present of elderly men is more than elderly women. These results were supported by (Mecheser,) who found that (60%) were male and (40%) were female⁽¹³⁾. Furthermore, the study results revealed that previous professions that majority of the sample (34.1%) were housewife, (32.9%) were retired, (32.9%) were free business. This result may be because the women in our society not work and stay in home and take care to children. This result is against the finding of (Mecheser) who found that (62%) retired, (36%) unemployed⁽¹³⁾.

 

According to educational levels the results indicated that the majority (42.7%) were illiterates. This may be because these individuals were unfortunately did not have the chance to be enrolled in the education system because the nature of their life.. This outcome is supported by (Mecheser) who found that (38%) of his sample were illiterates⁽¹³⁾, also (Boralingaiah) revealed that (50.4%) of  his result were illiterates⁽¹⁾, also (Gupta) found that (57.7%) of the sample were illiterates⁽¹⁴⁾.

 

Relative to social status that the most of the sample (29.3%) were divorced. This result is supported by (Mecheser) who found that (34%) of the sample were divorced⁽¹³⁾.

 

The study result of the economic status indicates that the most of the sample (56.1%) were received salary from the social welfare. The social welfare give salary to people who don’t work and they have no salary and they need salary to service. This result is supported by (Mecheser) who found that (66%) of the sample were received salary from the social welfare⁽¹³⁾ and (Abolfotouh) who found that (36.3%) of the sample were received salary from the social welfare⁽¹²⁾, (Ubaidulla) who found that (26.56%) of the sample were received salary from the social welfare⁽¹⁵⁾.

 

In regard to financial support by family the results show that (89%) of the sample they were not supported by their families financially. ‏This may be because a large proportion of the elderly are neglected ‏ they are from their family and not supported by them. This result is supported by (Mecheser) who found that (94%) were not supported financially by their family⁽¹³⁾, the same result shows by (Boralingaiah) who found that (45.6%) were not supported financially by their family⁽¹⁾.

 

The study results shown the financial resources that the most of the sample (47.6%) their financial resources were not enough. The reason for that lack of adequate financial support from the families and their salary not enough to them. This result is supported by (Mecheser) who found that (46%) their financial resources were insufficient⁽¹³⁾.

 

The present study revealed that the most of the sample (45.1%) have moderate social isolation level, (36.6%) have severe social isolation level and (18.3%) of the sample have mild social isolation level. This may be because of that most of the elderly have ability to communicate with others and have good relation with others. These outcomes disagree with the results of (Abolfotouh) who found that (4.5%) of the sample have social isolation⁽¹²⁾, while (Iliffe) found that (49.1%) of the sample have social isolation.⁽¹⁶⁾

 

The findings of the study indicate that there is a high significant relationship between social isolation levels and the age of elderly people at account chi-square value 3.714 and expected value 0.91. The reason for this result age is an important factor that makes the human to acquire the experience in how to deal with people and mixing with them. This study were compatible with (Iliffe) who found relationship between social isolation and age.⁽¹⁶⁾

 

According to the age at admission which revealed that there is a high significant relationship between social isolation levels and the age at admission of elderly people at account chi-square value 4.274 and expected value 1.65. This may be because the most of elderly and admitted geriatric homes at age group (65-74) years which may make them suffered social isolation more than other ages in geriatric homes which lead to social isolation. This study were compatible by (Iliffe) who found relationship between social isolation and age at admission.⁽¹⁶⁾

 

Regarding to the residence years in geriatric homes which revealed that there is a high significant relationship between social isolation levels and the residence years in geriatric homes of elderly people at account chi-square value 9.351 and expected value 1.28. This may be because long-stay of elderly in geriatric homes, they feel and belonging to the society. This study were compatible by (Iliffe) who found relationship between social isolation and residence years in geriatric homes.⁽¹⁶⁾

 

Concerning with gender the findings of the study indicate that there is a significant relationship between social isolation levels and gender of elderly people at account chi-square value 7.162 and expected value 6.04. This may be because the nature of women were don’t reservation in its social relations with women's as they mix with other women easily. The study of (Iliffe) disagree with the present study findings. ⁽¹⁶⁾

 

Furthermore, the study results about previous professions indicate that there is a high significant relationship between social isolation levels and previous professions of elderly people at account chi-square value 12.668 and expected value 4.94. This may be because the person who has previous work were more mixed with society. This study were not compatible with (Iliffe) who found no relationship between social isolation and previous professions.⁽¹⁶⁾

 

The study about educational level indicates that there is a high significant relationship between social isolation levels and educational level of elderly people at account chi-square value 12.184 and expected value 1.46. This may be because the educator and cultured person has the ability in dealing and coping with social problems such as social isolation. This study were not compatible with (Iliffe) who found no relationship between social isolation and educational level.⁽¹⁶⁾

 

Relative to social status indicate that there is a high significant relationship between social isolation levels and the social status of elderly people at account chi-square value 6.735 and expected value 0.55. This may be because the person who has family and exposed to problems with them will suffer social isolation more than the others. This study were not compatible with (Iliffe) who found no relationship between social isolation and social status.⁽¹⁶⁾

 

The study result about the economic status indicates that there is a high significant relationship between social isolation levels and the economic status of elderly people at account chi-square value 12.117 and expected value 6.59. The reason for this result social problems which faced the individuals and impeding the psychological, spiritual and social compatibility with requirements of life. This study were not compatible with (Iliffe) who found no relationship between social isolation and economic status.⁽¹⁶⁾

 

In regard to financial support by family indicate that there is a significant relationship between social isolation levels and financial support by family of elderly people at account chi-square value 1.591 and expected value 1.65. The reason for that the financial support by family has a positive impact on the elderly, feel that the family connected with them, especially with emotional aspect and sense it in their family love for them. This study were not compatible with (Iliffe) who found no relationship between social isolation and financial support by family.⁽¹⁶⁾

 

The study revealed to the financial resources indicate that there is a significant relationship between social isolation levels and the financial resources of elderly people at account chi-square value 2.963 and expected value 2.20. This mean the income sufficient lead to the stability of mental state and the person integration in the society. This study were not compatible with (Iliffe) who found no relationship between social isolation and financial resources. ⁽¹⁶⁾

 

 

CONCLUSION:

All elderly people affected with the social problems in different levels and no significant relationship between financial support by family and financial sources and between males and females in a changing sex with social problems.

 

RECOMMENDATIONS:

1.      Using educational programs and awareness that encourage community and relatives of the elderly to interesting for elderly socially and economically.

2.      The study recommends to promotion, social support programs for elderly people and provide all possible means of support.  

3.      Establishing a supplement health center  with geriatric homes and provide him with all the capabilities required health include a special wing for physiotherapy operated by a rehabilitation team consist of an elderly doctor, rehabilitation physician, nursing staff, nutritionist, psychologist.

4.      Education through video and audio media need to embrace older and human treatment guaranteed dignity and respect.

5.      Use cognitive therapy to treatment some psychological conditions which afflicting the elderly suffering with depression, neurotic anxiety and obsessive compulsive.

 

REFERENCES:

1-       Boralingaiah, P.; Bettappa, P. and Kashyap, S.: Prevalence of psycho-social problems among elderly in urban population of Mysore city, Karnataka, india, journal of psychological medicine. 2012, 34(4): 1-2, 4, 8-9, 11-14, 16, 18-23.

2-       Dhara, D. and Jogsan, Y.: Psychology and Psychotherapy, Depression and Psychological well-being in Old Age, Journal of Psychology and Psychotherapy. 2013, Vol.3, No.3, pp.1,2. Available from: https://dx.doi-org/10.4172/2161-0487.1000117

3-       World Health Organization: Media centre, Mental health and older adults, 2015, No. 381, p.1.

4-       Guardian News: Population, Population of older people set to surpass number of children, 2016, p.1.

5-       Swarnalatha, N.: The prevalence of Depression among the Rural Elderly in Chittor District, Andhra Pradesh, Journal of Clinical and Diagnostic Research. 2013, Vol. 7, No. 7, p.6.

6-       The American Geriatrics Society: Health in Aging, Nursing Homes, 2012.

7-       Garone, M.: Skilled Nursing Care: What Is It? Copyright © 2016 Available from: SeniorHomes.com

8-       United Nations: Department of Economic and Social Affairs Population Division, World Population Ageing, 2013, p.1.

9-       National Institute for Health Research: Improving social isolation Disability and loneliness. U.K., virgin Care limited, 2013, First Steps, Version 3, p.4.

10-    Bruce, M.; McAvay, G.; Raue, P.; Brown, E.; Meyers, B.; Keohane, D.; Jagoda, D. and Weber, C.: Major depression in elderly home health care patients, Psychiatry. 2002, pp. 1367, 1368, 1372.

11-    Kaur, M.; Kaur, A.; Saggu, A.; Kaur, A.; Kaur, A.; Arundeep; Kaur, D.; Sood, B. and Kaur, S.: Comparative study on psychosocial stresses among urban and rural geriatric population in selected areas of district Ludhiana (Punjab), Nursing and Midwifery research journal. 2006, Vol. 3, No. 2, pp. 79-81, 83.

12-    Abolfotouh, M., A.; Daffallah, A., A.; Khan, M., Y.; Khattab, M., S. and Abdulmoneim, I.: Psychosocial assessment of geriatric subjects in Abha city, Saudi Arabia, Eastern Mediterranean Health Journal. 2001, Vol. 7, No. 3, pp. 481-484, 489, 490.

13-    Mecheser, A.: Assessment of biopsychosocial problems for institutionalized and noninstitutionalized geriatric people in Baghdad city, University of Baghdad. 2005, pp. 6, 46, 48, 139, 141.

14-    Gupta, S., K.; Varshney, A.; Tiwari, S., C. and Shinde, M.: The investigation of medical and psychosocial problems of geriatric population in the urban area of Madhya Pradesh in India, Open Journal of Internal Medicine. 2012, pp.170-171, 173-174.

15-    Ubaidulla, M.; Inamdar, I., F.; Aswar, N., R.; Doibale, M., K. and Narkhede, M., G.: Medical and psychosocial profile of geriatric population in field practice area of Nanded, India, Journal of Dental and Medical Sciences. 2014, Vol. 13, No. 3, pp. 29, 30, 32.

16-    Iliffe, S.; Kharicha, K.; Harari, D.; Swift, C.; Gillmann, G. and Stuck, A.: The implications for clinicians and commissioners of social isolation risk in older people. British Journal of General Practice, 2007, pp. 277, 278, 280.

 

 

 

 

Accepted on 28.06.2017          © RJPT All right reserved