A study on assessment of socio-demographic characteristics and pattern of health-care support among geriatric people residing in old age homes, Nandyal

INTRODUCTION

Aging is a universal phenomenon associated with deteriorating health status. It is said that nobody grows old merely by living in a certain number of years.¹ The world is rapidly aging the number of elderly aged 60 and above. Government of India adopted ‘National Policy on Older Persons’ in January, 1999. The policy defines ‘senior citizen’ or ‘elderly’ as a person who is of age 60 years and above.²

Census 2011, In India the geriatric population aged more than 60 years account for 7.5% of the total population and is projected to rise to 12.4% by the year 2026. Among 104 million people elderly persons in India, 53 million were females and 51 million were males. It is likely to increase to 10% by the year 2025 and 18% by 2050.³

A number of studies have discussed various reasons for the elderly to be in old age home. Lack of care in the family, insufficient housing, economic hardship and break-up of joint family are cited as reasons by studies carried out by Bansod et al.⁴

The government ensures effective planning of health-care services for the geriatric people and prepares a feasible design relevant to the country needs for implementing the plan. The problems related to the aging of the population are that of inadequate facilities for medical treatment and of providing economic and social support; hence the information on the morbidity profile and health care support of this population is necessary for planning their health-care facilities.⁵

The aged population has special health problems that are basically different from those of adult or young. Most diseases in aged are chronic in nature- cardiovascular diseases, arthritis, diabetes, stroke, cataract, deafness, cancer, chronic infections etc.⁶ Most often elderly may suffer from multiple chronic conditions, visual defects, hearing impairment and deterioration of speech which can cause social isolation.⁷

METHODS

A cross-sectional study was conducted in old age homes in Nandyal. The study took place from October 15 2019 to December 15, 2019 (2 months). A total of 180 study subjects were in this study. The study subjects included elderly men and women. The study sample was collected by convenience sampling using a pre-designed, pre-tested, semi-structured questionnaire. Statistical analysis using a SPSS version-22 and results expressed as a percentage, mean, standard deviation.

Inclusion criteria

A total of 180 elderly subjects (60 years and above) and those who were willing to give informed consent and who were present during the study were included in this study.

Exclusion criteria

Those who were not willing to give informed consent and who were not present during study were excluded.

RESULTS

This study was conducted after taking permission from Head of the Department and Institutional ethical committee and Head of the old age homes.

Table 1 shows socio-demographic characteristics of the study population.

Out of 180 subjects 96 (54%) were women, 84 (46%) were men. Majority of the elderly were in the age group of 71-75 years of age (31.7%) followed by 61-65 years of age (27.8%) and only 25.6% of respondents were in the age group of 66-70 years of age. In this study, majority of the respondents (77%) were widow/widower and 20 percent of the geriatric people were divorced and separated. Majority of the geriatric people were Hindu. 82.2% of elderly were illiterate. Majority of elderly belongs to low socio-economic class according to modified Kuppuswamy classification.

Table 2 shows pattern of health care support among geriatric people

Most of the elderly (37.8%) received treatment for their morbidities from the government hospitals, while 42.2% received it from private clinic/ hospital. For 17.8% of the elderly the health-care expenses were borne by their children. Among women, (21.9%) received healthcare expenses from children, while (26.2%) of men had their healthcare expenses borne by their own savings.

Among women, (58.3%) of the geriatric people received health care expenses from government schemes. Regarding health insurance, (16.7%) of the elderly population possessed it to bear the expenses. Children were bearing health care in 23% of the study subjects, and 23.3% of elderly were taking care of their family members. While, in 37.2%, it was taken care by itself only. Forty percentages of the study subjects were dependent on their children for the financial support, and 42.2% elderly people were independent for their financial support.

Table 3 shows the morbidity profile of the study subjects. Arthritis was higher in women (51%) compared to men (44%). Hypertension (20.5%) followed by acid peptic disease (20%), diabetes (12.7%), and uncorrected refractive error (14.4%) were chief morbid conditions among the elderly subjects. Proportion of hypertension was higher in men (28.5%) when compared with that of in women (13.5%).

DISCUSSION

This study was carried out to identify the socio-demographic characteristics, and pattern of health-care support among the elderly people residing in old age homes in Nandyal.

In this study, majority of the elderly were in the age group of 71-75 years of age (31.7%), followed by 60-65 years of age (27.8%). Study by Shraddha et al also revealed that 31.9% of study population belonged to age group of 60-64 years and 14.9% belonged to age group 70-74 years.² In this study, 46 percent were males and 54 percent were females. Similar findings were also observed in the study done by Baweja et al.⁸

In this study we found that (82.2%) of respondents were literate, 9.2% were educated up to primary level.

Purty et al also found similar high percentage of illiterates 78.7% among elderly person from rural Tamilanadu.⁹ It was found that 42.2% of the elderly people received the health care from the private clinics/hospitals when compared with the government hospitals (37.8%). Goswami et al study found 60% of the elderly persons sought treatment from private qualified and non-qualified doctors and only 22% utilized government facilities and the rest sought treatment from other sources.¹⁰

According to the 2005-2006 National Family Health Survey (NFHS) and District-Level Household Survey (DLHS) data, private facilities are more utilized compared with government facilities. This difference might be because of higher proportion of study subjects belonging to lower socioeconomic status.

This study (46.7%) of the elderly people, the healthcare expenses were borne by government schemes, which was found to be similar to the findings of Sharma et al Chinnakali et al, Thomas et al.^7,11,13 42.2% of elderly were financially independent and 40% found dependent on their children which was similar to the findings of Thomas et al.¹¹ While, 27% of men and 26% of women were supported by their all family members. Majority of morbid conditions was arthritis (48%), and hypertension (20.5%), followed by 20% were acid peptic diseases. It was lower when compared with the findings of Prakash et al.¹⁴

This study only restricted for old age homes and results are not applicable for general population. These are limitations of the study.

CONCLUSION

A study represents among elderly residing in old age homes in Nandyal. There should be separate geriatric clinics in private and government hospitals to deal with by the elderly. It was also highlighted that economic independence and the use of social security schemes among elderly is less. Based on these findings recommended that there is a need to develop geriatric health care services. Financial assistance and social security schemes are needed to enhance health care facilities, economic independence and utilization services.

ACKNOWLEDGEMENTS

Authors like to acknowledge to the elderly people who are residing in old age homes in Nandyal and for their active participation. They would like to thank Head of the Department of Management and study subjects. Government needs to provide more assistance in the form of social security schemes to these people.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

REFERENCES

1. 1. Kishore S, Juyal R, Semwal J, Chandra R. Morbidity profile of elderly persons. Eye. 2007;36(31):30-45.
2. 2. Shraddha K, Prashantha B, Prakash B. Study on morbidity pattern among elderly in urban population of Mysore, Karnataka, India. Int J Med Biomed Res. 2012;1:215-23.
3. 3. Census of India. Government of India. Chapter 2, Population Composition. Government of India, 2011. Available at: https://censusindia.gov.in/vital_statistics/SRS_Report/9Chap%202%20-%202011.pdf. Accessed on 14 April 2014.
4. 4. Bansod D, Paswan B. From home to old age home: a situational appraisal of elderly in old age home in Maharashtra. Help Age India Res Develop J. 2006;12(3):14-23.
5. 5. Director General of Health Services, Ministry of health and family welfare, Government of India, New Delhi. (2011). National Program for Health Care of the Elderly. Available at: https://main.mohfw.gov.in/major-programmes/other-national-health-programmes/national-programme-health-care-elderlynphce. Accessed on 14 April 2014.
6. 6. Kumari RS. Socio-economic conditions, morbidity pattern and social support among the elderly women in a rural area. Medical College. 2001.
7. 7. Sharma D, Mazta SR, Parashar A. Morbidity pattern and health-seeking behaviour of aged population residing in Shimla hills of North India: a cross-sectional study. J Fam Med Prim Care. 2013;2:188-93.
8. 8. Baweja S, Agarwal H, Mathur A, Haldiya KR, Mathur A. Assessment of Nutritional Status and related risk factors in Community dwelling elderly in Western Rajasthan. J Indian Acad Geriatr. 2008;4(1):5-13.
9. 9. Purty AJ, Bazroy J, Kar M, Vasudevan K, Veliath A, Panda P. Morbidity pattern among the elderly population in the rural area of Tamilnadu, India. Turk J Med Sci. 2006;36:45-50.
10. 10. Goswami A, Reddaiah VP, Kapoor SK, Singh B, Dey AB, Dwivedi SN, et al. Health problems and health seeking behaviour of the rural aged. Ind J Geront. 2005;19:163-80.
11. 11. Thomas V, Lavanya KM, Muraleedhar. Morbidity profile and health seeking behaviour of the elderly in urban slums of Hyderabad, Andhra Pradesh, India- a cross sectional study. Int J Curr Res Rev. 2012;04(19):174-80.
12. 12. Gupta I, Dasgupta P, Sawhney M. Health of the elderly in India: some aspects of vulnerability. Discussion paper series No. 26. Delhi, India: Institute of Economic Growth, 2001.
13. 13. Chinnakali P, Mohan B, Upadhyay RP, Singh AK, Srivastava R, Yadav K. Prevalence and health seeking behaviour. N Am J Med Sci. 2012;4(11):558-62.
14. 14. Prakash R, Choudary SK, Singh US. A study of morality pattern among geriatric population in an urban area of Udaipur Rajasthan. Indian J Community Med. 2004;29(1):35-40.