The Problems and Effects of Old Age
Chapter One
Purpose of the Study
The main and most crucial purpose of this study is to investigate the extent to which the problems of aged people with particular reference to Udi Local Government Area could be solved. This is because the old people are of much value to the society, for they are seen as the custodians of tradition and culture in any society. They are instrumental in maintaining per feet peace and order, by setting minor disputes outside the law court the study however seeks.
- To identify the causes of aged people’s problems and offering suggestions on how they will be solved.
- To make investigation and good aspects of becoming old, so as to erase in the minds at people the idea of repressing getting old.
- To ascertain ways of bringing to the knowledge of the public a standard living pattern that can make the days of aged people most healthy and psychological depressions that canaccompany old age.
- To faster stronger human relationship with the aged people and other members of the community so as to make lifemore enjoyable to them.
- To find out other factors hinder the sustainability of oldpeople in the area of the case study.
CHAPTER TWO
LITERATURE REVIEW
Concept health as related to ageing
Health is a concept that is not easily defined as it has several meanings depending on how one perceives it. The definition of health becomes even more complex when referring to the older people). For example, an older person suffering from diabetes or even hypertension when asked how he/she feels would say he/she is fine. Even in appearance, that individual may look fine, yet in actual fact this particular individual has a medical problem. The variety of definitions of what is ageing that emerged from the literature might also explain the complexity of defining health as related to ageing.
Thompson (1996:15) defines ageing as ‘growing old, giving the appearance of advancing age’. Keith (1982) defined old age as ‘a basis for sorting individuals into categories’, and he places the concept of old age or older person, in a social context.
However, Davies (1998: 21) defines ageing as ‘a progressive loss of adaptability with time so that the individual is less and less able to react adaptively to challenges from the external or internal environment’. This suggests that with time, the individual becomes progressively more frail and in need of increasing support to maintain his or her autonomy. Several countries (Apt, 1997; Irvine et al, 1986; Kennie, 1993; Roach, 2001) defined ageing in terms of the official retirement age and have used it as a measure to indicate the beginning of old age. However, this official retirement age varied from country to country. For example, people retire at 55 years in Nigeria, 65 in South Africa and 60 in the Democratic Republic of the Congo. Previously, all the people over the age of 60 years were grouped under the category of being old. However, it has been recognized that much diversity exists among different age groups, especially in late life (Eliopoulos, 2001; Irvine et al, 1986).
From a health perspective, old age begins around 75 years and above, and this is referred to as functional age, fourth age or biological age. Functional or fourth age is considered as the operational definition of old age as there is an increase in medical disorders and resultant physical and mental disabilities among this age group (Kennie, 1993). In terms of health measurement, ageing is mostly defined in terms of functional age (Haslett et al , 2002). Functional age is seen as being reliable as it evaluates age in terms of functional performance (Kennie, 1993; Roach, 2001). It is most commonly used world wide for decision- making in terms of investigations and interventions (Haslett et al 2002).
However, it is argued that functionality has different meanings and is measured differently in different cultural contexts (Keith,1982). Measurement and meaning of functionality depends on what is required for full social participation in various settings.
This raises difficulties in establishing markers that can identify the functional age (Kennie, 1993). In high economy countries or affluent communities of the low economy countries, the level of functionality could easily be assessed or measured by the ability to climb stairs, taking a bath or clipping toe nails (Keith 1982). The chores of the poor people in Africa, Nigeria, inclusive are numerous and tedious, and range from walking long distances to draw water or fetching firewood. This creates difficulty in using standardised and acceptable measures and indicators of functionality.
In statistical terms, ageing is defined in terms of the number of years one has lived (chronological age). Chronological age rarely occurs alone, and according to the literature, reliance on chronological age could be misleading. It is acknowledged that chronological age usually occurs along with other definitions, such as retirement, physical decline, or change in mental attitude (Keith 1982). Keith (1982) observed that, when functional age rather than chronological age is used as an indicator of old age, the transition to old age is gradual. As it is thought that people who regard older people as a useful resource rarely define age in chronological terms. As compared to those who feel that people over 65 years are a burden. Several authors (Eliopoulos, 2001; Kennie, 1993; Roach, 2001) have defined the older persons in terms of both chronological and functional age.
The WHO defines health as ‘a state of complete physical, mental and social well being and not just the absence of disease’. Whitehead (1995) suggests that the above definition of health is based on the understanding that the individuals’ health is influenced by several factors that are often categorised into biological, physical and social environment, personal life styles and health services. The author refers to these factors as ‘layers of influence’, as they can have a health promoting or health damaging potential depending on the personal behaviour and the way of life that individual adopts.
Authors (Fuller, 2000; Whitehead, 1995) agree on the fact that individuals do not live or exist in isolation. By ‘being in the world’, they interact with other people. These interactions expose people to different types of social and community influences, which may have a potential to damage, or promote health.
Mutual support is one of such positive factors that result from the interaction in the community. Mutual support is capable of sustaining the health of the older people in what could have been unfavourable conditions. Lack of support, may lead to social isolation of the individuals that may adversely affect their health.
CHAPTER THREE
RESEARCH METHODOLOGY
Research design
The study employs quantitative descriptive research design to examine the problems and effect of old age among elderly people in Udi L.G.A. Enugu state.
Research Area
This study was carried out in Udi L.G.A, Enugu state. A state in the south eastern part of Nigeria.
Sources of Data
The data for this study were generated from two main sources; Primary sources and secondary sources. The primary sources include questionnaire, interviews and observation. The secondary sources include journals, bulletins, textbooks and the internet.
Population of the study
A study population is a group of elements or individuals as the case may be, who share similar characteristics. These similar features can include location, gender, age, sex or specific interest. The population of this study consists of care givers, and youths of Udi ea council.
HAPTER FOUR
ANALYSIS, PRESENTATION AND INTERPRETATON OF RESULTS
DEMOGRAPHIC DATA OF RESPONDENTS
CHAPTER FIVE
CONCLUSION AND RECOMMENDATION
CONCLUSION
A phenomenological study of ageing amongst the older persons in Enugu was undertaken with a purpose of learning the cause and effect of old age.
The need to undertake this study derived from the challenges posed by the complexity of the meaning of the concept ageing, the nature of age-related health problems, the current trend of population ageing, the social impact of HIV and AIDS, and the prevailing socio-economic situation of the country. The literature reviewed suggested these factors might have negative or positive impact on the quality of life of the older people and influence their perceptions about the ageing phenomenon. The literature reviewed also suggested that enhancing or maintaining the quality of life of the older people is a social and moral obligation of governments and society as a whole. However, the available evidence suggested that Nigerian government and society was not adequately prepared to care for the older people. It was in view of the above challenges and problems that the study was undertaken.
Looking at the lived experiences of the older persons of Nigeria, the main results of the findings showed that three dimensions (health, socio-economic, and psychosocial) should be considered in the understanding of the lived experiences of the older persons of Nigeria. The study suggests that the lived experiences of the older persons of Nigeria comprises of three dimensions: health, socio-economic, and psychosocial emerging from deteriorating health status, inappropriate health care services, insecure source of income, lack of/ or poor social welfare services, lack of social support, and psychological distress; associated with a variety of negative feelings and meanings.
The health dimension of the lived experiences of the older persons is characterizes by deteriorating health status and inappropriate health care services. The deteriorating health status emerged from the chronic health conditions and other age- related problems. These conditions were viewed as restricting physical mobility and autonomy of the older persons to perform activities of daily living and other activities they used to do. They also expressed frustration and concern toward the above changes. Inappropriate health care services emerged from their interactions with the public health services, which were viewed as unfriendly, unaffordable and inaccessible.
The socio-economic dimension of the lived experiences emerged from a context of financial dependence, inability to meet their basic needs, and poor living conditions. It was characterized by insecure source of income and lack of/or poor social welfare services; and viewed as loss of social status associated with fear of being neglected, anxiety and despair.
The psychosocial dimension of the lived experiences of the informants emerged from the deaths of breadwinners (spouses and adult children or relatives), the limited resources, the deteriorating health status, and the lack of social welfare services. This dimension was characterized by lack of social support, and psychological distress. It was deduced that the older persons of Nigeria are living in a psychosocial environment which lacks social support and characterised by psychological distress associated with the negative meanings and feelings such as social burden, loss of companionship and isolation, selective social prejudice, hopelessness, helplessness, and search for love and affection.
In conclusion, the main findings of this study indicated three most significant dimensions of the lived experiences of the older persons: health; socio-economic and psychosocial. These dimensions need to be taken into account when planning for any programs or interventions aimed at maintaining or improving the quality of life of the older persons of Nigeria. These interventions and programs should also address the negative feelings or meanings attached to the above experiences. The main findings of this study also show that; the meaning of being older or ageing in Nigeria does not only depend on the health, socio-economic and psychosocial living experiences of the older person but largely depends on the inner values of the older persons. Which include spiritual, emotional and cultural beliefs. This means that maintaining or improving the quality of life of the older persons in Nigeria would require comprehensive programs or interventions that should take into account the health, socio-economic, psychosocial, spiritual, emotional and cultural needs of the older people.
RECOMMENDATIONS
In view of the main results of the findings of this study, it appears that there is an urgent need to implement specific measures in order to improve the quality of life of the older people in Nigeria. Such measures should target the health status of the older persons, the health care providers, the health care services, the social welfare services, the psychosocial well being of the older persons, spiritual and cultural beliefs of the older persons.
It is therefore recommended that:
Older people should be regarded as vulnerable group and treated accordingly. This can be achieved by raising community awareness regarding problems affecting the older persons, setting up of geriatric clinics within the existing health facilities and mobile clinics to attend to the health problems of the older people. Raising awareness of the community regarding problems affecting the older persons in the country might lead to a change of attitude and the provision of support. The provision related to the older people in the current health policies need to be adhered to and reinforced by relevant authorities. The older people need to be educated about the age-related problems, self-care practices and their rights to access quality care and services.
Formal geriatric training should be developed and made available to health professionals in the country. In –service training, seminars on geriatric nursing should be offered to nurses, and other health professionals attending to the older persons. Formal training or in-service training of nurses and other health professionals would increase their understanding of the ageing and age-related problems and equip them with knowledge and skills to provide quality care to the older people. This would also change their attitudes towards the older people.
Specific social welfare measures need to be taken to assist the older persons with their financial and basic needs. As shown in this study, the social burden experienced by the older persons due to the social changes and the impact of HIV and AIDS is of great concern. Such assistance would require not only the involvement of the government, but the community, the non- governmental organizations, and the society at large. It means that structures should be put in place to register and evaluate the needs of the older persons.
New ways of extending the social network of the older people should be investigated. The traditional reliance on family members as primary source of support is no longer relevant due to social economic changes. Given the changes in the family structure, and loss of the cohesiveness of the extended family, care of the older people should now be considered a public
issue. The prevailing economic powerlessness of the older people need not be seen as a familial burden but a shared responsibility with the state and other stakeholders. The family should only operate as a safety net device, which should provide basic necessities of life and death. Support groups for the older people should be established within the different communities. These support groups will offer the older persons the opportunities to share their problems, give mutual support and instil hope amongst them.
The current social welfare policies need to be extended and adapted to the living experiences of the older people. The revised policies should include provision of legislation, governance, and financial, material resources and possibly care services that ensure full participation of the older persons. The existing Pension scheme, which favours only those in the formal sector employment, should be reviewed. Though being on pension is no guarantee for financial security. The process of accessing the pension is very long and tedious. In most cases the pension payments are meagre, erratic and over devalued to an extent that they cannot sustain subsistence.
Further research should be taken to establish the coping strategies used by the older people in dealing with their living experiences. Research should also be taken to establish the impact of the socio-economic experiences of the older persons on their well being, to validate the meaning ascribed to being old or ageing by the informants of this study in a big sample.
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