Functional Status of the Elderly and their Rehabilitation Needs: A Mixed-Method Study in a Slum of Kolkata, West Bengal
DOI:
https://doi.org/10.33192/smj.v75i1.260526Keywords:
Activities of daily living, elderly, functional status, instrumental activities of daily living, rehabilitationAbstract
Objective: A comprehensive understanding of the requirements of elderly is necessary to preserve their “functional capacity”, an important indicator of their health status. This study aimed to assess the functional status of the elderly and their rehabilitation needs.
Materials and Methods: A mixed-method study was conducted from November 2021 to June 2022 at a health centre in Chetla, West Bengal, India. Quantitative data, collected from 172 elderly persons using a pretested questionnaire, were analyzed by logistic regression analysis. Qualitative data, collected via focus group discussions, were analyzed
thematically.
Results: Overall, 11.62% and 66.86% participants were functionally dependent in one or more activities of daily living (ADL) and instrumental activities of daily living (IADL), respectively. Significant association of age ≥70 years (AOR = 4.06, 95% CI= 1.13-14.63), male gender (AOR= 5.21, 95% CI= 1.57-17.28) and assistive device use (AOR= 6.92, 95% CI= 1.85-25.83) was found with ADL limitations. Increasing age (AOR= 1.29, 95% CI= 1.13-1.50), female gender (AOR= 13.97, 95%CI= 3.61-54.00), residence in joint family (AOR= 3.95, 95%CI=1.47-10.61), without spouse (AOR= 3.59, 95% CI= 1.12-11.44) and daily intake of multiple medications (AOR= 4.99, 95%CI= 1.45-
17.13) were factors significantly associated with IADL limitations. Major identified needs of the elderly were related to development of peer support groups, transportation systems and delivery of services from the health system.
Conclusion: Rehabilitative services like providing assistive devices to the needy, developing elderly support groups, undertaking household visits for bedridden and those with restricted mobility, and building supportive environments within families and communities should be ensured.
References
Training Manual on Elderly Care for Medical Officer at Ayushman Bharat – Health and Wellness Centres. Ministry of Health & Family Welfare. Government of India. Available from: https://nhsrcindia.org/
Ageing and health [Internet]. [cited 2022 Jan 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
Ageing and disability | United Nations Enable [Internet]. [cited 2022 Jan 15]. Available from: https://www.un.org/development/desa/disabilities/disability-and-ageing.html
International Classification of Functioning, Disability and Health (ICF) [Internet]. [cited 2022 Jan 15]. Available from: https://www.who.int/standards/classifications/international-classificationof-
functioning-disability-and-health
Stuck AE, Walthert JM, Nikolaus T, Büla CJ, Hohmann C, Beck JC. Risk factors for functional status decline in communityliving elderly people: a systematic literature review. Soc Sci Med [Internet]. 1999 [cited 2022 Jan 15];48(4):445-69. Available from: https://pubmed.ncbi.nlm.nih.gov/10075171/
Judge JO, Schechtman K, Cress E. The relationship between physical performance measures and independence in instrumental activities of daily living. The FICSIT Group. Frailty and Injury: Cooperative Studies of Intervention Trials. J Am Geriatr Soc [Internet]. 1996 [cited 2022 Jan 15];44(11):1332-41. Available from: https://pubmed.ncbi.nlm.nih.gov/8909349/
Millán-Calenti JC, Tubío J, Pita-Fernández S, González-Abraldes I, Lorenzo T, Fernández-Arruty T, et al. Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Arch Gerontol Geriatr. 2010;50(3):306-10.
Ćwirlej-Sozańska A, Wiśniowska-Szurlej A, Wilmowska-Pietruszyńska A, Sozański B. Determinants of ADL and IADL disability in older adults in southeastern Poland. Available from: https://doi.org/10.1186/s12877-019-1319-4
Patel R. Prevalence and Determinants of Activity of Daily Living and Instrumental Activity of Daily Living Among Elderly in India. 2021 [cited 2021 Nov 24]; Available from: https://doi.org/10.21203/rs.3.rs-523499/v1
Burman J, Sembiah S, Dasgupta A, Paul B, Pawar N, Roy A. Assessment of Poor Functional Status and its Predictors among the Elderly in a Rural Area of West Bengal. J Midlife Health [Internet]. 2019 Jul 1 [cited 2021 Jun 6];10(3):123-30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31579173
Keshari P, Shankar H.Prevalence and spectrum of functional disability of urban elderly subjects: A community-based study from Central India. J Fam Community Med 2017;24:86- 90. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426108/pdf/JFCM-24-86.pdf
Saha I, Paul B. Essentials of Biostatistics & Research Methodology. 3rd ed. Kolkata: Academic Publishers, 2020.p.86-114.
Zimet G. Multidimensional scale of perceived social support (MSPSS)-scale items and scoring information. Johns Hopkins Univ Press [Internet]. 2016;(December):50-52. Available from: https://openscholarship.wustl.edu/bsltests/2977
Courses O. Geriatric Depression Scale (GDS) Short Form. Clin Gerontol. 1986;5(1):5-6.
Wallace M. Katz Index of Independence in Activities of Daily Living (ADL) [Internet]. [cited 2021 Jun 3]. Available from: www.ConsultGeriRN.org.
Lawton MP, Brody EM. Assessment of older people: Selfmaintaining and instrumental activities of daily living. Gerontologist [Internet]. 1969 [cited 2022 Jan 16];9(3):179-86. Available from: /record/2011-21299-001
Majhi MM, Bhatnagar N. Updated B. G Prasad’s classification for the year 2021: consideration for new base year 2016. J Family Med Prim Care. 2021[cited 2022 Apr 17];10(11):4318-9. Available from: https://pubmed.ncbi.nlm.nih.gov/35136812/
Chalise HN, Khanal B. Functional Disability on Instrumental Activities of Daily Livings Among Rural Older People in Nepal. J Karnali Acad Heal Sci [Internet]. 2020;3(3):1-6. Available from: http://jkahs.org.np/jkahs/index.php/jkahs/article/view/338
Nagarkar A, Kashikar Y. Predictors of functional disability with focus on activities of daily living: A community based follow-up study in older adults in India. Arch Gerontol Geriatr [Internet]. 2017 Mar 1 [cited 2022 Jan 22];69:151-5. Available from: https://pubmed.ncbi.nlm.nih.gov/27936458/
Veerapu N, A. PB, P. S, G. A. Functional dependence among elderly people in a rural community of Andhra Pradesh, South India. Int J Community Med Public Heal [Internet]. 2016 Dec 28 [cited 2022 Jan 22];3(7):1835-40. Available from: https://www.ijcmph.com/index.php/ijcmph/article/view/319
Hung Y-C, Chen Y-H, Lee M-C, Yeh C-J. Effect of Spousal Loss on Depression in Older Adults: Impacts of Time Passing, Living Arrangement, and Spouse’s Health Status before Death. Int J Environ Res Public Health [Internet]. 2021 Dec 10 [cited 2022 Jan 22];18(24):13032. Available from: https://pubmed.ncbi.nlm.nih.gov/34948641/
Das A. Spousal loss and health in late life: moving beyond emotional trauma. J Aging Health [Internet]. 2013 Mar [cited 2022 Jan 22];25(2):221-42. Available from: https://pubmed.ncbi.nlm.nih.gov/23271727/
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