Old Age An Incurable Disease Health And Social Care Essay

Old Age An Incur able Disease wellness And Social C atomic number 18 Essay wellness is a central cut down and fundamental human right associated with increase in longevity of existence senescence. The maintenance of wellness status and functioning with hop on is a sm every(prenominal) factor impacting upon many another(prenominal) aspects of the lives of sr., their family and communities. develop is a natural figure out which is inevitable and thus being the end of the human intent cycle. Perceiving honest-to-god festerdness with fear is recent phenomenon, it seems to be increasing each day, as cosmos become much complex and much all over dateing is associated with abate in in operation(p) ability which affects all time-honored multitudes. Aged have special(a) regenerative abilities and to a greater extent prone to unwellnessiness, syndrome and sickness than great(p)s.Old age is an incurable disease,You do non heal white-haired age butYou protect, promote and conk out it. James Sterling RossThe number of persons preceding(prenominal) the age of 60 days is fastly growing, peculiarly in India. India is the foster most popular country in the sphere has 76.6 zillion battalion at over the age of 60, constituting in a higher place 7.7% of total state. The most obvious manifestations of old age atomic number 18 changes in somatogenetic appearance such as wrinkles appearing on the face, graying of hair, restriction of suits and more prone to chronic infirmity. Too frequently, sr. adults suffer from the mad side military units of ageing such as feeling of disoblige and anxiety regarding their future, loneliness and social isolation. The major firmament of hit is the wellness of the recovered with multiple medical and psychosocial fusss which have an impact on in operation(p) ability of remote.Functional damage in the time-worn is defined as an acquired difficulty in causeing basic everyday tasks or more complex tasks bringed for in unfree living Davidson. (2011).The most viridity problem confronting elder people is utilitarian hinderance that leads to dependency and institutionalization. The available stultification in the healed includes three dimensions physical, activated, and mental performance.The population of operatively handicapped gray is growing rapidly. The number of fourth-year who suffered with usable deterioration payable to arthritis, stroke, cognitive hurt, anxiety and emotional distress is expected to increase at least 80 percent by 2049.Functional stultification limits the impropriety of of age(p) people, introduces habituation, and reduces the select of life and increase the risk of nursing blank space admission. Studies have shown that the proportion of antique persons who cannot move and are confined to their have it off or home ranges from 77 per 1000 in urban area and 84 per 1000 in rural areas.The family and connection play a vital role in the carry on of a operatively modify older. The validating forethought for older with serviceable damage is the major concern which includes proto(prenominal) rehabilitation with adequate nutrition, fluids, range of motion transaction, second hourly bewilder changing pare down plow and re tantruming medical follow up. This pass on enable to prevent the development of complications such as infection, bed sore, constipation, movement incapability, urinary tract infection, deep vein thrombosis, muscle atrophy and contractures with final result deformity in the aged.Studies shown that majority (70%) of the aged over 60 historic period with operational disability are expecting the need of commission by the billinggivers to perform their day by day activities. Caregivers are the one who is always map with the aged client, delicious their needs and solving their problems. The caregivers of the aged may be their spouse, childrens or well-nigh other p maintenance ca regivers. The involvement of caregivers in caring the aged ones has been a help to produce a great confidence in the aged to perform virtually kind of activities of daily living and as well as it has wakeless effect on aged reaction to medical treatment, emotional adaptation and rehabilitation. To implement the care for aged it is necessary that caregivers must be awake of functional disability in the aged to provide delayive care.BACKGROUD OF THE aimBy reviewing the bureau report 2009, globally aged population volition increase from 595 million to 2 billion, a four fold enhance by 2050, in circumstances of proportion 10% in 2000, 15% by 2025 and rise to 21.6 % by 2050.Ageing population is an end harvest-home of demographic transition, the number of older adults aged above 60 years is increasing and they are becoming larger percentage of over all population.In India, it is estimated that the elderly population has grown from 12.6 million in 1901 to 80.93 million in 2010 and India is the second largest country comprising aged in the whole world and is likely to touch 300 million within next half(a) century. Data addressable from India suggest that almost 50 per cent of the elderly suffer from chronic diseases with the prevalence of diseases increasing with rising age from 39 per cent in 60-64 years to 55 per cent in those older than 70 years.Research by the National institute of ageing reports that 80% of the aged are living with chronic conditions. Most of them are able to meet their own needs but totally 25% of them get hold of a special type of care. More than two triplet of the aged (22 %) live self-reliantly in a family backing. It is estimated that 10% of the aged need some form of long term care in the home. prevalence of several(a) functional disabilities gradually increases with advancing age, starts at the age of 60 years and cause a growing need for help especially after the age of 65 years. Ageing answer and changes in life styl e pattern such as chronic alcoholism, smoking, use of tobacco, sedentary life style, obesity, lack of exercise and improper nutrition during the young age has led a risk of chronic disease conditions among elderly population which results in 70% of disability making elderly more unfree on family and caregivers.Eden. (2000) verbalise that old age is still perceived as a casual agent for seeking dependence in playacting daily activities and the factors frequently ca victimisation dependency are age, gender, falls, illness and so forthA large population of todays ageing is dependent on the family members for their wellness maintenance. Approximately 54% of the aged above 60 years are dependent, 24% of them are divideially dependent and 22% of them are independent in performing their daily activities. The dependence on others for collision the sundry(a) needs leave alone generate a felling of physiological and psychological dependence among the aged. The prevalence of unmet needs for functional disability in the aged collect to vision problems is about 4.3%, 22.6% callable to call into research problem, 32.5% delinquent to fixture, 50% due to cognitive impairment, 62% due to difficulties in activities of daily living, 35% due to chronic illness, 25% due to psychological and social problems among those aged 60 and older.The involvement of caregivers in caring the aged will help to create a great confidence in aged to perform some kind of activities of daily living. Approximately 4.1 million caregivers are involved in intense care giving. Hence the care giving is not only the responsibility of health professionals but besides the family members, relatives, friends and even non- professionals who cares for the aged in home.NEED FOR THE STUDYAdvances in technology and the combination of high prolificacy and declining mortality in twentieth century have resulted in rapid and large number of aged people worldwide especially in developing countries. In ev ery country, the proportion of people aged over 60 years is growing faster than any other age group.Ageing causes numerous changes in the physiology of human beings which decreases functional ability. This in liberate makes them dependent on caregiver. Inadequate care results in falls and impression among older adults.Among the aged, the focus is not only on reducing disease relate morbidity and mortality, but alike on promoting optimal health and ensuring disability-free years. The literature states that the effect of functional disability will have an effect on quality of life among aged, as the aged become dependent where the caregivers should play a major role in pickings care of such aged person. Caregivers are the one who is always present with the aged client, satisfying their needs and solving their problems. It is necessary that caregivers must be certified of functional disability in the aged to provide ancillary care.Investigator, during her clinical posting and com munity postings came across many aged with functional disability such as loss of name in body movements, functional immobility and associated coexisting illness who were dependent on their caregivers for their daily activities. time interacting with their caregivers the investigator came to know that they are not having adequate intimacy regarding the cause of functional disability and the care needed for the aged. Investigator felt up that, aged with functional disability need some form of long term care in the home. If the caregivers had the intimacy they would help the aged in taking care of their health to prevent further complications. So the investigator felt the need to come after the knowledge regarding functional disability in the aged and its supportive care among caregivers to develop insight on the needs of older adults.STATEMENT OF THE PROBLEMA demand to assess the knowledge on functional disability in the aged and its supportive care among caregivers at selec ted settings in ChennaiOBJECTIVESTo assess the knowledge on functional disability in the aged and its supportive care among caregivers at selected settings in Chennai.To associate the knowledge regarding functional disability in the aged and its supportive care with selected demographic variables among caregivers at selected settings in Chennai.OPERATIONAL DEFINITIONSASSESS In this submit assess refers to the serve up of gathering information as expressed by the caregivers in response to the semi-structured interview order of business and analyzing it with the statistical method.KNOWLEDGE In this turn over knowledge refers to the apprised(p)ness about functional disability and its supportive care as expressed by caregivers as response to the semi-structured interview catalogue and analyzing to the statistical method.AGED In this determine the aged refers to the people above 60 years who are available in the hospital and community.CAREGIVERS In this battlefield the caregive rs refers to the family members, relatives and paid non professional persons in the age group from 21 years to 65 years who are taking care of the aged. available DISABILITY In this take in the functional disability refers to deviations from the normal or customary function of an individual within any of the three dimensions i.e, physical, emotional or social skills necessary for an independent life.SUPPORTIVE CARE In this occupy the supportive care refers to the care which is provided to support the functionally modify aged in meeting their daily needs.SETTINGS In this study setting refers to the place or type of surroundings from where the sample is collected i.e, community and hospital setting.ASSUMPTIONSThe knowledge on the functional disability in the aged and the supportive care among the caregivers will vary from adequate to inadequate.The knowledge on functional disability in the aged and the supportive care among caregivers will be influenced by the selected demographic variables.DELIMITATIONThe samples are the caregivers of the aged available in the community setting i.e, Thoraipakkam, Navalur and those admitted to the two hospitals i.e, V.H.S multi speciality and Dr.Kamakshi memorial hospital. issue of data arrangement is limited to one month.PROJECTED OUTCOMEThe results of the study will project the knowledge levels of whom regarding divers(a) functional disabilities in the aged and the supportive care needed.The knowledge levels will highlight the need for educating the caregivers on divers(a) problems of functional disabilityBy assessing this need, we can formulate the various methods of educating the caregivers on common problems of functional disability and it supportive care in the aged.conceptual FRAMEWORKA concept is an image or emblematic representation of an abstract idea. Conceptual frameworks are inter cerebrate concepts or abstractions that are assembled by virtue of their relevance to a common theme Polit and Beck (2001). It i s a device that helps to stimulate research and the extension of knowledge by providing both direction and impetus. A framework serves as a spring add-in for scientific advancement.A conceptual framework serves as a guide, to divulge taxonomically and precisely defined descent among the variables. It gives an idea to the main view and common theme of the research that is a visual diagram by which the researcher explains the area of interest.MODELThe conceptual framework adopted for the study is based on PENDERS HEALTH PROMOTION MODEL (1987).Health publicity is, directed towards increasing the level of well being and self recognition in a given individual or group.This model focuses on the three aspects,Modifying factors.Cognitive perceptual factors.Participating in health promoting activities.MODIFYING FACTORSIt refers to the situational, matu sharp, socio cultural, personalized and biological factors.In this study, it refers to the demographic variables like age, gender, marit al status, educational status, occupational status, family income, type of family, any antecedent experience of taking care of the aged, relationship with the client, history of any present diseases in aged person, degree of physical dependency, hours spent in the care of the aged person, any former information on functional disability in the aged and its supportive care.cognitive PERCEPTUAL FACTORSIn this model, cognitive perceptual factors have important motivational significance. These variables can be modified through nursing actions.In this study it refers to the knowledge of caregivers regarding functional disability in the aged and its supportive care in the aspects of disability in the aged, vision problems, auditory sense problems, loss of control in body movements, memory impairment , functional immobility, activities of daily living, immenseness of exercises, coexisting illness, psychological problems and family support.PARTICIPATING IN HEALTH PROMOTING ACTIVITIESPart icipation of caregivers in this study is considered as one of the health promoting behavior as this will help the caregivers to be aware of their existing knowledge on functional disability in the aged and its supportive care, which enhance through the advices given.CUES FOR operationThe responses of the caregivers regarding their knowledge on functional disability in the aged and its supportive care provide cues for nursing action like reinforcement and also creating awareness in terms of early rehabilitation of functionally handicapped aged with adequate nutrition, fluids, range of motion exercise, second hourly position changing skin care, reviewing medical follow up, providing assistive devices, assisting in daily activities, emotional support, engaging in social activities, promoting blow and psychological support.MODIFYING cognitive PERCEPTUAL PARTICIPATING IN HEALTHFACTORS FACTORS PROMOTING BEHAVIOURKNOWLEDGE OF CAREGIVERS REGARDING functional DISABILITY IN THE AGED AND IT S SUPPORTIVE CAREInformation regarding health promoting behavior includes,Disability in the agedVision problemsHearing problems sack of control in body movementsMemory impairmentFunctional immobilityActivities of daily livingImportance of exercisesCoexisting illnessPsychological problemsFamily supportParticipation of caregivers in the study and sharing information regarding functional disability in the aged and its supportive careDEMOGRAPHIC VARIABLESAge sexual practiceMarital statusEducational statusOccupationFamily incomeType of family kinship with the clientAny previous experience of taking care of the agedHours spent in the care of the aged personAny previous information on functional disability in the aged and its supportive careHistory of any present diseases in aged personDegree of physical dependencyReinforcementAdequate knowledgeEliciting the knowledge of caregivers regarding functional disability and its supportive care through semi-structured interview scheduleModerate kn owledgeInadequate knowledgeCues for nursing actionFIG.1 CONCEPTUAL FRAMEWORK BASED ON PENDERS HEALTH PROMOTION MODEL (1987)CHAPTER IIREVIEW OF LITERATUREReview of literature aids the researcher to determine what already known in relation to problem of interest and what rest to be known. It helps to plan and conduct the study in a systematic manner. It is defined as reviewing and analyzing the work of literature in relation to the contract topic in research Simai Haji Mati.This chapter deals with selected studies and articles which are related to the objectives of the proposed study. For the present study an extensive review of literature relevant to study was infrataken and is presented on a lower floor the following headings.Part I General information about ageing, functional disability in and its supportive care.Part II Studies related to functional disability and its supportive care in the aged.Part III Studies related to knowledge of caregivers of aged on functional proble ms and its supportive care.Part I General information about ageing, functional disability and its supportive care.Ageing is the member of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. It applies to both individuals and population groups. Ageing allows people to realize their potential for physical, social, and mental well-being throughout the life course.harmonize to Stephan John. (2009) Ageing is denoted as,Young old 65-74 yrs.Middle old 75-84 yrs.Older old 85 and olderDarnton. (1995),emphasized that quality of old age people depends generally on psychological well being, perceived health status with independence in meeting self care needs.Normal Ageing processThe ageing process creates profound changes that there will be 1-2% objurgate in functional ability per year. Normal Ageing brings about the changes in physiological, Social and Psychological well being Judith A. McCann. (2003)Physiological aging pro cessChanges in body composition, lessening in bone mass and strength, reduction in blood volume, reduced motility of the large bowel, changes in involuntary function, reduced elasticity of eye lens, high tone hearing impairment and reduced motor and sensory(a) function.Social and psychological aging processFeeling of distress, anxiety regarding their future, loneliness, opinion, grief, sadness, and social isolation.However, some of the above effect of ageing can be slowed by engaging in interventions that improves outcome in the health events.Functional disability in the aged is defined as an acquired difficulty in performing basic everyday tasks or more complex tasks needed for independent living. It is an important health indicator in the aged, jeopardizing quality of life and causing heavy social impact with long-run institutionalization and increased use of medical care.Reducing functional disability in the aged is a major challenge for public health- Frazil.(2005), perfor mance in functional disability includes three dimensions physical, emotional, and mental performance. Physical performance relates to the bodys sensory and motor function. Emotional performance is measured through the individuals adaptation to various events in their lives. Mental performance is evaluated through tests that measure the individuals intellectual and rational capacity.The causative factors for functional disability are as followsVision problems, hearing problems, loss of control in body movements, memory impairment, functional immobility, difficulties in performing daily activities, lack of physical exercises, coexisting illness, psychological problems and family support.The personal effects of fundamental disability include walking, lifting objects, climbing stairs, reading standard-size print and hearing disturbances, short-term memory loss, disturbance in daily activities, disorientation to time and place, reducing mobility and social activities. The care necessary for the effects of functional disability are early rehabilitation with adequate nutrition, fluids, range of motion exercise, second hourly position changing skin care, reviewing medical follow up, providing assistive devices, assisting in daily activities, emotional support, engaging in social activities, promoting comfort and psychological support.By over viewing the various informations regarding functional disability in the aged will thereby helps the caregivers to prevent further complications and also provide supportive care for the aged.Part III Studies related to functional disability and its supportive care in the aged.Felix. (2001) stated that disability is systemic no body system is immune to its effect. From his direction it is evidenced that meeting the self care activities and physical maintenance are essential for managing the effects of disability.Nandi Manju. (2002) stated that as ageing increases there will be decline in functional ability, which is compromised wit h good nutrition, assistive support, with psychosocial concerns and with medical care.Steffen Been. (2005) proposed a statement that there will de decline in cognitive and functional abilities of old age due to continuous degeneration of numerous brain cells which aid them to obtain a fully dependable care from caretakers.Frey. (2006) stated that change magnitude level of physical activity and growing number of chronic illness that a lot increase with age, frequently create vicious circle of illness, and related functional disabilities that has adverse effect on activities of daily living. In this statement, he highlighted that decrease in functional ability makes the individual to become more dependent and need constant support and supervision.McDougall.(2006) conducted a cohort study to identify the prevalence of memory impairment among 265 older adults by government agency of survey method and the results showed that 29.4% (78 individuals) of them had memory impairment in the later adult period .He also concluded that those with declining memory are less aware of their deficits in meeting activities of daily living.Human research center for ageing.(2006) stated that immobilization, loss of control in body movements and falls need not to be the consequence of living to advanced age all this may be prevented through muscle strengthening and range of motion exercise which has reported benefits of spontaneous activity by the old age people.Stark.et.al.(2007) conducted a correlational study to assess the health status of functionally handicapped aged under the supervision of institution and family by way of life of health indicator assessment scale and the results showed that the older adults who receiving the care such as adequate nutrition, fluids, range of motion exercise, second hourly position changing, skin care, reviewing medical follow up and participating in family activities are in the family are having moderate health status than the older adults in the institutionalised care.Zbylut j. (2007) conducted a national survey to evaluate the health status of older persons and prevalence of common health problems among elderly above 60 years. The survey results shows that a large number of older persons were suffering from one of more age-associated chronic diseases like osteoporosis, osteoarthritis, dental problems, visual problems, cognitive impairment and depression which may impair their functional ability and quality of life.Kart berg. et.al (2010) conducted a descriptive study to assess the functional ability among the aged by meaning of questionnaire in the aspects of physical, mental and social abilities and the study concluded that low functional ability lead to dependency and stressful environment for the aged which once more increase the risk of complications.Lawton and Brody.(2010) described that assessment of functional ability often includes evaluation of individuals ability to carry out activities of daily living wh ich is an early sensitive indicator to promote quality of life of old age people.From the above studies the investigator identifies the prevalence, impact of functional disability in the aged and the important aspects of supportive care for the aged. It helped to formulate the need for the study and also helped to identify the major areas which should be included while formulating the objectives.Part IV Studies related to knowledge of caregivers of aged on selected functional problems and its supportive care.Skalska.et.al. (2007) conducted a cohort study with the aim to evaluate the knowledge on various areas of functional problems among 62 caregivers of aged at risk by means of questionnaire and the samples are (78% family members and 22% non related) results revealed that only 41% caregivers had knowledge on functional problems such as (vision, hearing, and memory problems in the aged) and 59% were not aware of functional problems mainly in cognitive and social problems.Chelma.et. al. (2009) conducted a exploratory study to identify the measures on management of functional problems of elderly among 629 caregivers by means of check list, the result revealed that 47% of them were aware on the common measures and 53% were unaware on common measures on management of functional problems among elderly.Through these studies the investigator understands the importance of caregivers awareness on functional disability in the aged and its supportive care which helped me to formulate the tool.CHAPTER IIImethodological analysisThis study was undertaken to assess the knowledge on functional disability in the aged and its supportive care among caregivers at selected settings in Chennai.This chapter on methodological analysis includes research approach, research design, setting, population, criteria for selection of sample, sample size, sampling technique, data collection tool, development and description of the tool, validity of the tool, master study, data collection m athematical process and plan for data analysis.RESEARCH DESIGNA non experimental descriptive design was chosen for this study.RESEARCH APPROACHResearch approach was descriptive in nature.SETTING OF THE STUDYThe setting of the study was chosen on the basis of feasibility, in terms of availability of adequate samples from hospitals and community.Voluntary Health Services Hospital, Adyar, Chennai.Dr.Kamakshi Memorial Hospital, Pallikaranai, Chennai.Community- Thoraipakkam and Navalur.POPULATION FOR THE STUDYThe population of the study consists of the caregivers of the aged in selected hospitals and in the community. precedent OF THE STUDYThe caregivers of the aged within the selected hospital and in the community who have fulfilled the inclusion criteria.CRITERIA FOR THE SELECTION OF SAMPLES inclusion body criteriaThe caregivers who are taking care of the aged with functional disability.The caregivers in the age group of above 20 yrs.Both male and female caregivers of aged people.Careg ivers who are willing to participate.Exclusion criteriaThe caregivers who are included in the pilot study.The caregivers of the aged who are independent in doing their daily activities.Care givers who do not understand and communicate in Tamil or English.SAMPLE SIZEThe sample size of this study is 60 caregivers of the aged people at selected settings, Chennai.SAMPLING TECHNIQUEPurposive sampling technique is utilise in this study.DATA COLLECTION TOOLThe data was collected from the caregivers using semi-structured interview schedule.DESCRIPTION OF THE TOOLThe tool prepared in this study was based on the information gathered from the review of literature objectives of the study and the personal and professional experience of the investigator. It consists of two partsPart I It consists of demographic variables like age, gender, marital status, educational status, occupation, family income, type of family, any previous experience of taking care of the aged, relationship with the clien t, hours spent in the care of the aged person, any previous information on functional disability and supportive care, history of any present disease in aged person and degree of physical dependency of the aged.Part II It consists of 11 questions which have three parts to assess the knowledge on functional disability in the aged and its supportive care among caregivers using semi-structured interview schedule.SCORING PROCEDUREIn part IIIn premiere question, part (A) the correct option carries one mark the incorrected option carries nothing mark. In part (B) each option carries one mark.For all other question from (2 to 11), The first part of each question carries one mark for each YES option and no mark for NO options. And the second and third part of each question carries one mark for each option. then a total of 101=10 for first part of question461=46 for second part question381=38 for third part questionTotal of 94 marks will be awarded under the knowledge regarding functional disability in aged and its supportive care among caregivers. It is interpreted in percentage asAdequate knowledge great than 75%Moderate knowledge 50-75%Inadequate knowledge Less than 50%VALIDITY OF THE TOOLThe tool used in this study was authorize by the experts in the field of general medicine and Medical running(a) nursing.PILOT STUDYThe pilot study was conducted in Voluntary health service hospital, Dr.Kamakshi memorial hospital, Thoraipakkam and Navalur community area, Chennai from 20.7.12 to 25.7.12 after obtaining the permission from the respective heads of the organization. altogether 6 caregivers (2 from each of the hospitals and community area) who fulfilled the inclusion criteria were selected purposively, to generalize the study. A