A study on changed lifestyle of the elderly living in old age homes of pune city

doi:10.21203/rs.3.rs-1534116/v1

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A study on changed lifestyle of the elderly living in old age homes of pune city

https://doi.org/10.21203/rs.3.rs-1534116/v1

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Increase in old age homes and its residents mandates attention to the living condition of elderly at such institutions. The study is based on information collected from 500 residents of 23 old age homes of Pune city. A multistage random sampling was adopted for the sample selection. A semi-structured interview schedule, which was approved by the research ethical board of the institute, was used to gather the information from the respondents. The study also has gathered qualitative insights using case studies and key informant interviews.

About half of the respondents were having issues while adjusting to the old age home environment and similar percent has reported that their life has considerably changed after joining the old age home. Three-fifths of these have experienced negative impact, such as homesickness, feeling of staying at a hostel, elderly have to adjust in their daily life, follow certain schedule, and so on. Yet, surprisingly, almost all respondents reported that the care and services available at old age home are good and they are satisfied with it. Due to family attachment, many respondents feel lonely. For instance, 56 percent of the respondents perceive that they are being left out by their family members. Hence, they would like to go back to their families. Despite the fact that more than two-fifths (44%) of the respondents know that they will have their last breath at the old age home. Whereas, half of the respondents said they are not certain about their future stay and 3 percent believe that very soon they will return to their homes.

Almost all respondents are satisfied with the available facilities at the old age homes. Yet, the issues of uncomfortable living, loneliness, or similar unpleasant feeling is present among some of the respondents. These experiences are mostly due to the absence of family members in surrounding.

living condition

old age home

adjustment

family

elderly

Population ageing is considered to be one of the biggest challenges of demographic transition in the twenty-first century. Decreasing fertility rates and increasing longevity have resulted in a higher population of elderly people (aged 60 years and above) compared with the younger and adult population than ever before. Although developed regions were the first to witness the phenomenon of population ageing, now the developing regions are witnessing a rapid growth of aged population. With slower increase of aged population, many developed countries took decades to adjust to the changing age structure. In contrast, several less developed countries are experiencing rapid changes in age structure. Hence, they need to adapt quickly and work on new policies that ensure the well-being of the elderly people, including support and care since they might experience tremendous strain due to the rapidly changing structure of the population, particularly posing a challenge for health systems. For instance, with increased longevity, many of the elderly would require some form of long-term care, the cost of which needs to be borne by their families. This might result in family members withdrawing from school or employment to care for the elderly member. Hence, older people are viewed as a burden [1]. Traditionally, within the familial hierarchy elderly people have enjoyed a high status. However recently, with the increase in age, several elderly people experience eroding status. In addition to other factors, it contributes to the behaviour of the elderly towards their families and their living arrangement [2].

There is rise in elderly living alone and according to BKPAI [3] report marriage of children is the main reason for elderly to live alone. The other reasons include death of spouse, family conflicts, and migration of children. In addition, the demand for old age homes increased. Some evidences indicate that the increase in old age homes was seen largely in the southern regions of the country, particularly in Kerala and Tamil Nadu, then in the western state of Maharashtra.

As the number of old age homes and its residents is increasing, there is need to study the issues of elderly who are living in old age homes, which is covered in this paper. In particular, the paper analyses the living condition of the elderly at old age home, and the changes they have experienced after joining the old age home [4]. Source of income plays an important role in the social status of the elderly. For instance, pension of the elderly enhances their acceptability among their family members, relatives and others. Pensioners are less likely to be considered as a burden on the family [5, 6].

A contradictory view comes from [7] who contested the generalized perception that nobody goes happily to old age homes. According to her, even when not living alone, some of the elderly perhaps felt unwanted either because family members were too busy or there was a shortage of space. There were others who did not want to depend on their relatives but did not have the courage to live in old-age homes [8]. This allowed them to maintain good relations with their relatives and enjoy their company for a short while when they occasionally visited them without leaving the security of their old-age homes.

Based on literature and other available information Pune city of Maharashtra was selected to conduct this study. The information of all the old age homes and number of elderly people therein by some of their background characteristics is not available. Although the list of old age homes in Pune city was available, some of them were not functioning and basic details such as the number of residents and their elementary particulars were not available. That means the prevalence of elderly staying in them was not accessible. Therefore, a total of 500 elderly persons from 23 old age homes in the city were interviewed. This study is based on both qualitative and quantitative methods. For this purpose, a semi-structured interview schedule was used which was approved by the Students’ Ethical Review Committee (SERC) of the Institute. After the data collection, data entry, cleaning and analysis were done using MS-Excel and STATA software.

Sampling Design

Basically, multi-stage sampling was adopted to carry out this study. The old age homes were selected by simple random sampling. Since the list of old age homes in Pune city was available through HelpAge India (NGO)[9], it was possible to apply simple random sampling for their selection. Thereafter, selected old age homes were contacted to get permission to interview the residents. Later, samples were collected using the proportion of the size of the old age homes to the total size of selected old age homes. Finally, the required number of respondents were selected using systematic random sampling.

Inclusion And Exclusion Criteria

The Inclusion criteria included only those elderly who were aged 60 years and above, currently living in old age homes and who had spent at least one year in the OAHs. Those old age homes were not included which had not completed at least two years of functioning. In this study, those elderly were excluded who were unable to respond and those suffering from psychological problems.

Among those who perceive that their life has considerably changes at old age home, 38 percent have experienced positive changes, such as improvement in health, timely food, care and support, and so on. In this context, share of male respondents (47%) is higher than the female (35%). In addition, respondents aged 80 years and above have the higher share than the other age groups.

When 38 percent reported that they have experienced positive changes after joining the old age home, remaining (62%) have experienced negative changes, which is the result of staying away from home. Since many respondents don’t want to be at old age home. Figure 2 presents the responses of the elderly regarding the care provided at the OAHs. About four-fifths (79%) of the respondents reported that they receive good or better care and 19 percent of them experienced the care given is usual. Very few (2%) are not satisfied with the care received at old age home. A most common response was, “Here, at old age home, we have to follow a routine. There is a schedule for every activity and we cannot follow our own preferences.”

Most of the time respondents feel lonely due to loss of a partner or a close, or family member leaves them. Table 1 shows that more than half (55%) of the respondents feel lonely at old age home. This share is slightly high among male respondents (58%) compared to female (54%). This feeling of lonely is higher among young-old (aged 60–69) respondents (62%) compared to other age groups. While, respondents with better education level are least likely to feel lonely or left out by family members compared to respondents with no or lower education levels.

Table 1

Respondents feeling loneliness at old age homes, Pune (%)
Background characteristics	Feel lonely or left out
Background characteristics	Yes	No	Total
Sex
Male	57.6	42.4	184
Female	54.4	45.6	316
Age
60–69 years	62.1	37.9	132
70–79 years	52.8	47.2	212
80 years or more	53.9	46.2	156
Educational level
No schooling	59.1	40.9	66
< 5 years	59.0	41.0	61
5–7 years	65.2	34.8	89
8–10 years	54.6	45.4	119
11–12 years	50.0	50.0	52
Up to graduation	47.8	52.2	90
Total	55.1	44.9	500

(Table 1)

Table 2 provides information about the intentions of the elderly about their future stay at OAHs. More than Half (54%) of the respondents said that they have to spend their remaining life at the old age home, while 41 percent are not sure about their continued stay in future at old age home. Very few (2%) perceived that they will soon leave the old age home and return to their former homes. The perception of staying at old age home for remaining time is higher among female respondents (57%) than the male respondents (48%). The same share increases with the age of respondents. Whereas, the share least among the respondents with higher education level than the respondents with no schooling or the least years of schooling.

Table 2

Future intentions of the elderly about staying in the old age home, Pune (%)
Background characteristics	Length of stay in the OAH
Background characteristics	Till death	Not known	Will go soon	Others	Total
Sex
Male	47.8	46.2	3.3	2.7	184
Female	57.3	38.3	1.9	2.5	316
Age
60–69 years	46.2	48.5	3.0	2.3	132
70–79 years	55.7	40.1	1.9	2.4	212
80 years and above	57.7	36.5	2.6	3.2	156
Educational level
No schooling	54.6	43.9	0.0	1.5	66
< 5 years	62.3	36.1	1.6	0.0	61
5–7 years	47.2	44.9	4.5	3.4	89
8–10 years	64.7	31.1	3.4	0.8	119
11–12 years	46.2	48.1	1.9	3.9	52
Up to graduation	46.0	46.9	1.8	5.3	113
Total	53.8	41.2	2.4	2.6	500

(Table 2)

Table 3 presents the perception of respondents about those aged persons who are staying with their family members at home. About two-thirds (64%) perceive that those aged persons staying with their family members are better off than themselves. This perception is least among aged 80 years of above compared respondents from other age group. This share is higher among female respondents (68%) than the male respondents (62%). The share is least among those respondents who have completed more than 12 years of schooling (56%).

Table 3

Elderly perceiving that another elderly person is better off and the elderly feeling loneliness at old age homes, Pune
Background characteristics	Others are better off
Background characteristics	Yes	No	Total
Age
60–69 years	66.7	33.3	132
70–79 years	68.4	31.6	212
80 years and above	60.9	39.1	156
Sex
Male	62.0	38.0	184
Female	67.7	32.3	316
Educational level
No schooling	69.7	30.3	66
< 5 years completed	65.6	34.4	61
5–9 years completed	68.5	31.5	89
10 years completed	68.9	31.1	119
11–12 years completed	69.2	30.8	52
Graduation and above	55.8	44.2	113
Total	64.4	35.6	278

(Table 3)

Though half of the respondents reported that their lifestyle is quite different at old age home compared to their former residences, includes both positive and negative perspectives [10]. Furthermore, only 38 percent of the respondents reported that the change has brought positive experiences, such as improvement in health, availability of care-taker, food and other basic facilities. Since, many respondents joined the old age home in harsh circumstances. Some required shelter and timely food, while some respondents were suffering from health issues and required health services [11]. In addition, many respondents shared that old age home provides all required services, which are not affordable for them to access at their former residence [12]. As a result, almost all respondents agreed that they receive good care at old age home. Yet, more than half (55%) of the respondents reported that they feel lonely at old age home, for being away from the family members or familiar surroundings [13]. This perception is higher among young-old respondents and lowest among respondents with more than 12 years of schooling. Since, young-old respondents are the freshers at the old age home and others have spent a considerable time, hence this difference has been witnessed among respondents aged 60–69 years and aged 70 and above. More than half of the respondents have accepted that they have to spend their remaining life at the old age home. Still, several elderlies are not sure about their continued stay in future at the old age home. They still hope that they may get a chance to return to their former lives. Moreover, some of them want to return to their former surroundings, so they are not ready to accept the significant fact. About two-thirds (64%) of the respondents perceive that those other elderlies who are staying with their family members or at their own home are having a better life. It provides additional information regarding perception of respondents about staying with family members and staying in old age home.

Old age homes are providing all the required facilities and elderly residents are also satisfied with it. But government should address some vital issues of the elderly, and accessible and affordable health service is one of it [14]. Since, some of the respondents were suffering from health issues and could not afford required services on their own. So, they moved to old age home. The additional benefits include, old age home also provides care-taker and other basic facilities. Nutritious and timely food is another requirement of the elderly. Since, some respondents were not receiving it at their former place, they joined the old age home.

Ethics approval and consent to participate

This study was approved by the Institutional Review Board (IRB) of International Institute for Population Sciences, Mumbai, India. Written informed consent was obtained from all participants. All methods were carried out in accordance with relevant guidelines and regulations.

Consent for publication

Not applicable

Availability of data and materials

The datasets generated during and analyzed during the current study are not publicly available due to the risk of compromising participant confidentiality but are available from the corresponding author on reasonable request.

Competing interests

The authors declare that they have no competing interests.

Funding

This study did not receive any funding.

Authors' information (optional)

Affiliations

Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, 400088, India

Priyanka Janbandhu

Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, 400088, India

Santosh Phad

Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, 400088, India

Dhananjay Bansod

Corresponding author

Correspondence to Priyanka Janbandhu.

Authors' contributions (This statement must exactly match on Editorial submission system and in the manuscript)
Ms. Janbandhu has prepared the research objectives and collected the data from field.

Mr. Phad has analysed the data and contributed in interpretation of data and participated in writing manuscript.

Prof. Bansod mainly guided in completing this study and provided advice in preparing the manuscript.

All authors reviewed the manuscript.

Acknowledgements

We are grateful to the residents and caregivers of the old age homes of Pune city who were included in this study.

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No competing interests reported.

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A study on changed lifestyle of the elderly living in old age homes of pune city

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Abstract

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Introduction

Data And Methods

Sampling Design

Inclusion And Exclusion Criteria

Results

Discussion

Declarations

References

Additional Declarations

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