Institutionalization of the AgedDr. Sr. Severine Menezes SAP

M.S.W, D.Coun, M.A, M.Phil, M.S, PGDHR, Ph.D

Sisters of St.Ann of ProvidenceMangalore

Institutionalization of the Aged

Introduction on

Ageing

Begins at birth – at

the time of conception

Inevitable and irreversible

process

a socially constructed

concept

Continues throughout

life and until death

considered as a social reality.

Not an event but a

process

social phenomenon rather than

physiological,

As per the WHO guidelines people 60-74 years of age are called elderly and those between 75 and 85+years of age as old. The world is rapidly aging: the number of people aged 60 and over as a proportion of the global population will double from 11% in 2006 to 22% by 2050.

Demographic Transition in the World

India is in the teeth of a demographic transition. Its elderly population is 7.5 percent of total population

(seventy five millions). The older population which is 56.7 millions in 1991

began growing to over 76 million by the year 2001 and 137 million in 2021.

Demographic Transition in India

1. Government old age home2. Private Home for the ageda. Unpaid/Non-profit old age homeb. Private Paid old age home

Various types of Old Age Homes

1. Changes in Social Contact2. Loneliness3. Health Problems4. Emotional Instabilitya. Anxiety and Fearsb. Sadness and Depressionc. Anger and Irritabilityd. Apathye. Jealousyf. Self Neglectg. Guilt

Challenges faced by the Aged due to Institutionalization

5. Adjustment Problems6. Lack of Social Support7. Forced Lifestyle8. Lack of interest in the surrounding

Challenges faced by the Aged due to Institutionalization

Statement of the problem: The statement of the research problem is ‘Institutionalization of the Aged.’ The present study is an attempt to identify the reasons to get into institutions for the elderly, life of the elderly in the institutions and the challenges faced by them in these institutions.

Methodology of study

The theoretical approach assesses that age is socially constructed and one aim is to deconstruct superficial and biased knowledge of ageing.

A) Biological Theories. Accumulative-Waste Theory Wear-and-Tear Theory Somatic Mutation Theory Error Accumulation TheoryB) Non Biological theories.

Disengagement Theory Selectivity Theory Continuity Theory Modernization Theory Activity theory: Active ageing turns into successful ageing which is to be

achieved by denying the onset of old age and by replacing those relationships, activities, and roles of middle-age that are lost with new ones in order to maintain activities and life satisfaction.

Theoretical Framework

1.To analyze the reasons for institutionalization of aged persons.

2.To study and understand the life of the aged within the institutions.

3.To assess the degree of respect, security and belongingness experienced by the aged within these institutions.

4.To study the impact of institutionalization on the aged. 5.To assess the ability of the aged to cope with the

problems and stresses in the institutions.

Objectives of the Study

The present study is carried on in Mangalore city from 09 Homes for the aged out of which 07 are private and 02 are run by the Trust. There are no Homes run by the Government in the city. Out of the nine Institutions for the aged, only three are charity based and the others are paid. All the residents of Home for the Aged in Mangalore city are included in the study. There are 842 elderly in 09 Institutions, out of which 300 respondents are selected for the research study.  

Universe of the Study

Sampling Design

Simple random sample is used, because in this sample each and every individual of the population has an equal chance of being included in the sample. To obtain the numbers that could represent the total population, the researcher calculated the total number of residents with 35 percent of the respondents. The total sample size was 296. For the purpose of the study the researcher took up 300 samples.

Inclusion Criteria

1. The respondents include those who are 60 years of age and above.

2. The respondents living in the institutions situated in Mangalore city.

3. The respondents include both male and female residing in the institutions.

4. The respondents who can comprehend instructions.5. The respondents who are willing to participate in the

study.

Exclusion Criteria

1. It excludes those respondents who are not in the Institutions.2. It also excludes those respondents who have the history of mental and physical disability like hearing impediment, terminal

illnesses, etc.3. It excludes also those who are seriously ill

or bedridden people.

Pilot Study

A Pilot study was conducted to assess the efficiency of the tool of data collection before arriving at the final tool which helped in altering the tool so that the researcher was prepared to foresee the possible difficulties.

Research Design

The present study is an attempt to obtain and assess the information concerning situation and the challenges faced by the elderly in the institutions for the aged. Therefore the study carried out by the researcher using the descriptive design.

Data Collection Data is collected from both Primary and secondary sources of Data.Primary data is collected through the personal interview method with the tool of interview schedule.Secondary source of data is collected through books, journals, articles published in various books and magazines.

Tools and techniques1. Interview Schedule.2. Measurement of Scales: Lawton MP and Brody EM (1969) developed

Instrumental Activities of Daily Living Scale to evaluate the elderly’s ability to perform the more complex activities that are necessary for optimal independent functioning.

3. UCLA Loneliness Scale by Russel Peplau and Ferguson developed in 1978, consisted of 20 statements that reflected how lonely

individuals .4. MOS Social support inventory: Medical Outcomes Study (MOS), Social

Support Measurement developed by Cathy Donald Sherbourne and Anita L. Stewart in 1991 has focused on the structure of interpersonal relationships.

5. The Perceived Stress Scale developed by Cohen, Kamarck and Mermelstein in 1983. The Perceived Stress Scale (PSS) is the most widely used psychological instrument for measuring the perception of stress.

6. Geriatric Anxiety Inventory (GAI) is a 20 items self-report measure of anxiety. Gerard J. Byrne1 and Nancy A. Pachana (2007) created a reliable, valid and easy to use instrument for anxiety that is specifically targeted at older adults.

MAJOR FINDINGS It was discovered more than half of the sample size of the

respondents that is 183 were female respondents and 117 were male respondents. 110 (36.7%), having 69 (37.7%) females and 41 (35.0%) males are between the ages 70–79 which shows a larger faction of the sample population is aged.

Majority of the respondents for the study are Christians comprising of 276 (92.0%) of the total respondents having 175 (95.6%) females and 101 (86.3%) male respondents and the remaining part of the respondents are Hindus having only 24 (8.0%) with 8 (4.4%) females and 16 (13.7%) male respondents constituted less than one-tenth of the respondents. There are no residents belonging to Muslim and SC/ST.

The analysis on marital status of respondents indicated that majority of the elderly are widowed that is 203 (67.7%) of the total population with 129 (70.4%) female and 74 (63.2%) male respondents. 72 (24.0%) of the respondents comprising of 43 (23.4%) female and 29(24.8%) male respondents are those who had never married.

It is evident that 86 (28.7%) of the sample elderly respondents having 57 (31.1%) females and 29 (24.8%) males are illiterate.

MAJOR FINDINGS

The analysis on the elderly shows that majority of the respondents that is 226 (75.3%) comprising of 119 (65.0%) females and 107 (91.4%) males do not have any income and are dependent on charity or some other financial assistance.

Majority of the respondents 130 comprising of 71.0% female and 97 male comprising of 82.9% respondents are living in the institution for 1 to 10 years. Nearly 44 of the total respondents, 32 (17.5%) female and 12 (10.3%) male respondents are living in the institution for 11 to 20 years.

MAJOR FINDINGS

Majority of the respondents 150 (82.0%) female and 112 (95.7%) are happy with the persons who take care of them in the institution.

Majority of the respondents 148 (80.9%) female and 113 (96.6%) male feel that the caretakers in the institution show love and respect towards them.

The data revealed in the study that a good number of respondents 148 (80.9%) female and 112 (95.7%) male respondents feel secure in the institution.

The study also reveals that 145 (79.2%) female and 112 (95.7%) male respondents feel belonging in the institution.

MAJOR FINDINGS

A large majority, 263 (87.7%) were fully satisfied with the conditions in the Institution. Only 37 (12.3%) were not satisfied but they stay back in the institution as they have no other option of going back to their family.

The data on preference of stay shows 162 (88.5% ) female and 101 (86.3%) prefer to stay in the institution having all the benefits like spiritual, emotional, medical and psychological support in the institution though they have some feelings that they are away from the family.

MAJOR FINDINGS

Majority 117 (63.9%) female and 82 (70.1%) male felt happy for being institutionalized. One reason of being happy for having been institutionalized was that they had no one to take care in the family as their children had migrated and settled down in far off places. Some of them were happy as they found security and safety in the institutions since there are many cases of elderly being abused or murdered in their own apartments or houses.

MAJOR FINDINGS

Institutionalization affects person as a whole – physical, psychological, emotional social and spiritual. Health status of the institutionalized elderly was assessed.

Hypertension is the main disease most of the elderly suffer. Sixty six (36. 1%) female and 37 (31.6%) male respondents had hypertension before coming to the institution and 33 (18.0%) female and 11(9.4%) male respondents developed hypertension after coming to the institution.

The second main disease is Diabetes Miletus. Forty two (23.0%) female and 26 (22.2%) male respondents were suffering from diabetes Miletus before coming to the institution.

MAJOR FINDINGS

The appetite of the elderly before entering into the institution and after entering into the institution was assessed.

The researcher finds that majority that is 180 (98.4%) and 115 (98.3%) had good appetite.

MAJOR FINDINGS

To assess the emotional and psychological health, various scales such as Anxiety Scale, Loneliness Scale, Perceived Stress Scale and questions of the Interview Schedule 58, 59, 60, 61, 64, 65, 66 and 67 are being used.

Over all anxiety scale shows the female level of anxiety is 34.60 and the male level of anxiety is 30.33. The total level of anxiety mean value is 32.94. Test shows that the level of anxiety among the respondents is at moderate extent as the Mean score is 32.94. Percentage of Mean score in female is 54.06% and male 47.40% and the total mean percentage is 51.46%.

MAJOR FINDINGS

Loneliness is a major issue relating to quality of life and well being of the older adult. Loneliness scale is a 20 item questionnaire and each question is assessed on 4 point rating scale as Never, Rarely, Sometimes and Always. Over all Loneliness scale shows the female level of loneliness is 47.09 and the male level of loneliness is 48.34. The total level of loneliness mean value is 47.58. Test shows that the level of loneliness scale among the respondents is at high extent as the Mean score is 47.58. Percentage of Mean score is female 58.90% and male 60.40% and the total mean percentage is 59.50%.

The majority of the respondents, 138 (75.4%) female and 83(70.9%) male are having loneliness at a high extent.

MAJOR FINDINGS

The level of perceived stress scale among the respondents is significant as the total percentage of mean score for female is 32.78% and for male it is 35.93% and the total mean percentage is 34.01. The test proves that 126 (68.9%) female and 98 (83.8%) male respondents are having stress at a moderate level, 51 (27.9%) female and 12 (10.3%) male respondents are having lots of stress and the rest 6 (3.3%) female and 7 (6.0%) male are not stressed out at all.

Major findings of this study is that, overall social support, daily activity and physical self maintenance will result in coping with the stress and ill health.

MAJOR FINDINGS

The study is a descriptive design that investigated the life of the elderly in the institutions, the impact of institutionalization on the elderly, the anxiety, stress and loneliness attached to that, with a theoretical framework of Activity Daily Living and type of informal social support. Face-to-face interview survey method using a structured questionnaire was adopted for this study. Demographic data was collected from all participants who met the inclusion criteria. The data included age, gender, time of administering questionnaires, institution where the elderly lived, and length of stay in the home.

SUMMARY AND CONCLUSIONS

All the respondents were interviewed by the researcher and were asked the questions, to be answered. The tests were administered in the same order to make it consistent, and the time of the day when the tests were given was noted. Each interview lasted about 30-45 minutes depending on the level of functioning of the participants. Observation method also was used to get the desired report.

SUMMARY AND CONCLUSIONS

The Statistical Package for Social Sciences (version 13.0) (SPSS) was used for the analysis and modeling of the data.

Uni-variate analysis began with a descriptive analysis of demographic, independent, and dependent variables. Mean, median and standard deviation were utilized for continuous variables, while frequencies and percentages were applied to categorical variables.

SUMMARY AND CONCLUSIONS

Based on the information got through interviews, observation and the analysis got from the different scales used, the relationship between different variables studied the life of the elderly in the institution and the impact on physical, social, emotional and psychological health has been assembled together.

SUMMARY AND CONCLUSIONS

SUGGESTIONS

Government

assistance

Flexible in

rules and

regulations

Family’s responsibility

Organization and Institutions should come forward to help

Awareness among the younger generation

Thank you