Impact of Care Given by Community Health Workers on Management of Elderly Person in Gokana Lga.
CHAPTER ONE
Objectives of the study
Specifically, the objectives of the study include to:
- determine the health workers level of knowledge of the physical, emotional and social care of the elderly in Gokana L.G.A., Rivers State
- determine the attitude of the health workers towards the care of the elderly.
- determine the health workers practices in the provision of care for the elderly.
- identify the factors that influence health workers attitude of care towards the elderly in Gokana LGA.
CHAPTER TWO
LITERATURE REVIEW
Conceptual Review
Concept of Ageing
Aging is a universal phenomenon that is obvious as well as inevitable. Old age is a significant stage in life and normally related to life expectancy of given area, hence the conditions and the needs of the aged becomes imperative. Preparation for old age cannot be over emphasized. Aging can be observed as a consistent pattern of change that every human being undergoes, starting at a very slow rate at around age 30, and progressing at a more rapid rate beyond age 65 (Olowookere, 2003). Aging is a sensitive and seriously regarded issue and it is a process of becoming older. The aged in Nigeria are highly revered, respected and often held in high esteem. The aged constitute a repository of wisdom and experiences.
The aged are often seen as the custodians of knowledge due to their experience in life.
The population of old people throughout the world is increasing at a very rapid rate (Population Reference Bureau, 2011). The most rapid increase is taking place in the developing world with Africa alone projected to have between 204 and 210 million old people by the year 2050. This unprecedented rise in the number old people presents fundamental socio-economic difficulties (Olaleye, 2011). Nigeria with a population of 140.8 million people (NPC 2006) is the most populated nation in Africa and the ninth in the world (UN, 2005). Life expectancy at birth stands at 57.6 years (NPC, 2008). The population growth rate (2000 – 2005) is 2.5% with 5.6% of the total population aged 60 and above. As the most populous country in Africa, Nigeria currently has the highest number of aged or elderly people in Africa Population Reference Bureau(PRB, 2011) with the largest population in Africa and the ninth in the world, it is estimated that by year 2025, the population of Nigeria aged 60 and above will constitute 6 percent of the entire population as projected by (UN population Division, 2005)
Old age is not a disease; it is the phase of retrograde biological process in growth and development which leads to decreased powers of survival and adjustment. The World Health Organization has always designated as “Elderly” people aged 65 years and above. In 1980, the United Nations defined 60 years as the age of transition of people. (U N 2004). Older people make up an increasing proportion of the population in developed world and this demographic transition also affects some developing countries. Generally older people are at increased risk of disease, disability, social and financial deprivation compared to the younger generation in the same population (National Council on Ageing and older people (NCAOP), 2005). An increase in the number of older people will lead to increased demands on health and support services including aged care residential services and acute health service (Mccormacks, 2004).
Mcmurdo (2000) also stated that the elderly have reduced ability to generate resources; they lack the basic needs that affect their health status. Where one finds well developed Maternal and Child Health Services, a vacuum exists in the elderly health policy. Population growth combined with ageing will mean that greater number of older people will need health and community care services, more older people in the hospital mean more people with dementia needing appropriate care. Varice (2010) indicated that society where the elderly population is expanding and cultural values are changing, the needs of the elderly become increasing by entwined with appropriate health care needs. Death of older people both in institutional settings and the community have often been attributed to natural, accidental or undetermined causes when in fact they were consequences of abusive or neglectful behavior. As long as older people are devalued and marginalized by society they will suffer from loss of self identity and remain highly susceptible to discrimination and all forms of abuse (Szucs, 2001)
CHAPTER THREE
RESEARCH METHODOLOGY
Research Design
A Cross sectional descriptive study design was used to determine the impact of care of elderly among community health workers in Gokana L.G.A. Rivers State. According to Isangedihi, Joshua, Asim & Ekuri (2004), the descriptive study survey allows orderly collection of data. The cross sectional approach involves the collection of data at a point in time and considered suitable for the phenomenon being studied (Polit & Beck, 2006).
Population of Study
The population of study consisted of (402) doctors, (600) nurses, (10) dentists and (11) physiotherapists that provide direct clinical health care to elderly people making up a total of one thousand and twentythree (1023) health workers.
CHAPTER FOUR
PRESENTATION OF RESULTS
The results are presented in Tables and figures according to the research questions. Out of 461 questionnaires that were administered 460 questionnaires were returned giving a returned rate of 99.9%.
CHAPTER FIVE
DISCUSSION OF FINDINGS, CONCLUSION AND RECOMMENDATION
Discussion of findings
What is the level of knowledge of care of the elderly among community health workers in Gokana LGA. The findings in this study indicate that majority (95%) of the health workers had adequate knowledge on the basic needs and care of the elderly. The findings also revealed that health workers who had sufficient knowledge on the nutrition and personal hygiene of the elderly were also in the majority. The explanation for this may be because all the health workers have tertiary education and are already in specialized areas. This agrees with the finding of Okoye and Asa (2011) that knowledge on the basic needs of the elderly will help care givers to assist the elderly to meet their needs without compromising their health and safety. It is also in agreement with Mandy, Mitehell and Oneil, (2011) that higher level of education increases health workers knowledge of care of the elderly. However, this findings disagrees with Donatelle (2001) and Mcfarely and Morrison (2004) that posits that most curricula of health professionals have little or nothing to do about the elderly and as such most health workers have very poor knowledge on the care of the elderly.
What is the attitude of health workers towards the care of the elderly in Gokana LGA. The study reveals that the positive attitude of the health workers was higher than the negative attitude that they like taking care of the elderly; they called the patient by name and created a relationship with the elderly. This agrees with Mandy, Mitchel and Oniel (2011) that reported health workers have positive attitude towards the care of the elderly. It is also in line with the Oyetunde, Ojo and Ojewale (2013) opinion that there is positive attitude of health workers towards the care of the elderly. The positive attitude of health workers towards the care of the elderly in the study is probably due to high level of education and well trained health workers. This is in accordance with Nelson (2004) who concluded that trained health workers are more likely to develop positive attitude to the care of the elderly. And also agrees with Kaempfer, Wellam & Himburg, (2002) that opines that the higher the level of education the more positive the attitude towards the care of elderly among community health workers.
What are the factors that influence health workers attitude towards the care of the elderly?
These findings revealed that most of the respondents (97%) agreed that taking care of the elderly requires special training and those special wards should be created for the elderly (geriatric wards). This finding is probably because the elderly have some peculiarities that would require special care and also a cordoned area. The study also reveals that most of the health workers would not prefer this area of specialization except when they are being forced to. This agrees with Happel (2002), alliance for ageing research, (2003) and Bowen et al, (2008), whose findings showed that identification of geriatrics as a career choice amongst health workers and social care workers appear to be a long standing theme in literature.
Conclusion
In conclusion, health care professionals need to have the right skills to manage a more demanding role in the future. In order to offer effective services for the elderly people, a skilled workforce of health professionals is therefore very necessary.
Recommendations
Although the findings of the study show that health workers have good knowledge on the care of the elderly, the attitude of the health workers was statistically significant with mean years of experience i.e. the years of experience is associated with attitude of health workers. There is need to provide more resources and also training of personnel in area of elderly care.
- Special wards / department should be created for the elderly in the hospitals with well trained staff in the area of specialization.
- The researcher also suggested that the government should develop a health policy for the elderly that will capture the care of the elderly.
- Develop a system of periodical health workers evaluation to determine strategies of upgrading their knowledge and enhancing practice.
- Development of follow up courses and in service training programs should be conducted to maintain efficient performance of individuals previously trained in the care of the elderly
- Encouraging health workers to attend national and international congresses, seminars symposiums and workshops on care of the elderly.
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