Functional Status of Elderly in a Rural community at Ernakulam District

 

Anu Jacob Kachappillil¹*, Ninu Sophia², Ms. Anjitha Saji³, Ms. Angel Sebastian³,

Ms. Amitha Boban³, Ms. Aleena Thankachan³, Ms. Ancy Varghese³

¹Assistant Professor, Department of Medical Surgical Nursing, MOSC College of Nursing, Kolenchery.

²Assistant Professor, Department of Medical Surgical Nursing, MOSC College of Nursing, Kolenchery.

³Third Year BSc Nursing Students, M.O.S.C College of Nursing, Kolenchery

 

ABSTRACT:

Aim: A descriptive study was conducted to assess the functional status of elderly in a rural community of Ernakulam district. Background: Over the last decades, the world’s elderly population has increased exponentially and this tendency will continue during the coming years¹. Today, 8.5 percent of people worldwide (617 million) are aged 65 and over. This percentage is projected to jump to nearly 17 percent of the world’s population by 2050 (1.6 billion).² Loss of independence occurs as people age due to mobility restrictions, frailty, decreased functional fitness and cognitive abilities¹. The purpose of this study was to assess the functional status of elderly in a rural community and to find its association with selected demographic variables. Methods: A descriptive analytical study was conducted in a rural area of Ernakulam district. 340 elderly individuals, aged 60 years and above were selected by convenient sampling technique and interviewed by using structured interview schedule. Ability to perform Activities of Daily Living (ADL) was assessed by using Katz Index of activities of daily living Scale and Instrumental Activities of Daily Living (IADL) was assessed by using Lawton Brody Instrumental Activities of Daily Living Scale. Results: While assessing ADL by using Katz Index Scale, out of 340 elderly persons, 95.8 % were independent to perform ADL. The functional status of elderly assessed by using Lawton Brody Instrumental Activities of Daily Living Scale showed that, 87.3% were independent to perform IADL. 90% were able to use telephone, 81% were independent to do shopping, 89% were able to prepare food, 88% were able to perform housekeeping tasks, 89% were able to wash their clothes and 78% were able to go out independently. 94% of subjects were able to take responsibities of own medications and 90% were able to handle financial matters. Conclusion: The findings of the present study highlight that majority of elderly subjects had independence in ADL and IADL.

 

 

 

 

 

INTRODUCTION:

The human aging process is dynamic and progressive, triggering declines in functional capacity of the elderly.³ Elderly population, in India as well as world-wide, is increasing rapidly over the years. Elderly persons, being one of the most vulnerable groups of the society have more chances of chronic disease, infections, as well as disabilities. Although elderly persons may have chronic diseases that may not be amenable to cure, their functional disabilities, if recognized at an early stage, can often be improved greatly. Planning and delivery of health care services in this area would require information on the magnitude of the problem in the community.⁴ This study was carried out to assess the functional status of elderly people in a rural area of Ernakulam district.

 

 

 

MATERIALS AND METHODS:

A descriptive analytical study was conducted in a rural area of Ernakulam district. 340 elderly individuals, aged 60 years and above were selected by convenient sampling technique and interviewed by using structured interview schedule. Activities of Daily Living (ADL) were assessed by Katz Index of activities of daily living Scale.⁵ Instrumental Activities of Daily Living (IADL) were assessed by Lawton Brody Instrumental Activities of Daily Living Scale.⁶ Data were analyzed using SPSS version 20.

 

RESULTS:

Section A: Distribution of demographic variables:

Table 1: Frequency and percentage   distribution of demographic characteristics of elderly                                      n=340

Sl. No	Demographic Variables	Frequency (f)	Percentage (%)
1	Age in years a.  <68 b.  > 68	196 144	57.6 42.4
2	Gender a.        Male b.        Female	163 177	47.9 52.1
3	Marital Status a.        Married b.        Unmarried	272 68	80 20
4	Living Status a.        Living alone b.        Living with relatives c.        Living with spouse	10 295 35	2.9 86.8 10.3
5	Health problems a.        Yes b.        No	211 129	62.1 37.9

 

Table 1 shows that among the 340 elderly, majority (57.6%) were in the age group below 68 years. Nearly half of the subjects (52.1%) were females. Majority of subjects (80%) were married and (86.8%) were living with their relatives. More than half of the elderly (62.1%) were having health problems like hypertension, bronchial asthma, COPD, diabetic mellitus, arthritis etc.

 

 

Section B: Ability of elderly to perform ADL

Table 2: Frequency and percentage distribution of the ability of elderly to perform ADL                          n=340

Ability to perform ADL	Frequency(f)	(%)
Dependent to perform ADL	14	4.2
Independent to perform ADL	326	95.8

 

Table 2 shows that majority of elderly (95.8%) were independent to perform ADL.

 

Section C: Ability of elderly to perform IADL

 

Table 3: Frequency and percentage distribution of the ability of elderly to perform IADL                       n=340

Sl No.	IADL criteria	Able to perform IADL		Unable to perform IADL
		Frequency (f)	Percentage (%)	Frequency (f)	Percentage (%)
1	Telephone Use	305	90	35	10
2	Shopping	275	81	65	19
3	Food Preparation	302	89	38	11
4	House Keeping	299	88	41	12
5	Laundry	302	89	38	11
6	Mode of Transportation	264	78	76	22
7	Responsibility for own medication	318	94	22	6
8	Ability to handle finance	304	90	36	10

 

 

Table 3 shows that majority of the subjects (87.3%) were independent to perform IADL. 90% were able to use telephone, 81% were independent to do shopping, 89% were able to prepare food, 88% were able to perform housekeeping tasks, 89% were able to wash their clothes and 78% were able to go out independently. 94% of subjects were able to take responsibities of own medications and 90% were able to handle financial matters.

 

Section C: Association of the ability to perform IADL with selected demographic variables:

There was significant association between the ability to use telephone with the age of elderly (χ^{2 =} 38.49, P value = 0.001^*) at P <0.05 level of significance.

 

There was significant association between the ability to do shopping with the age of elderly (χ^{2 =} 54.59, P value =0.001^*), gender (χ^{2 =} 13.2, P value = 0.001^*) and health problems (χ^{2 =} 9.18, P value=0.002^*) at P <0.05 level of significance.

 

There was significant association between the ability to prepare food with the age of elderly (χ^{2 =} 28.8, P value=0.001^*) and health problems (χ^{2 =} 10, P value = 0.001^*) at P <0.05 level of significance.

 

There was significant association between the ability to perform house keeping with the age of elderly (χ^{2 =} 29.6, P value=0.001^*) and health problems (χ^{2 =} 11.9, P value = 0.001^*) at P <0.05 level of significance.

 

There was significant association between the ability to wash clothes with the age of elderly (χ^{2 =} 25.1, P value = 0.001^*) and health problems (χ^{2 =} 14.9, P value = 0.001^*) at P <0.05 level of significance.

 

There was significant association between the ability to go out independently with the age of elderly (χ^{2 =} 49.1, P value = 0.001^*), gender (χ^{2 =} 13.1, P value = 0.001^*) and health problems (χ^{2 =} 12.5, P value=0.001^*) at P <0.05 level of significance.

 

There was significant association between the ability to take responsibility of own medications with the age of elderly (χ^{2 =} 10.2, P value = 0.001^*) at P <0.05 level of significance.

 

LIMITATION OF THE STUDY:

In the present research study, only 4.8% of elderly were dependant to perform their ADL, hence the researcher was not able to find the association between the ability to perform ADL with selected demographic variables

 

DISCUSSION:

In the present study, majority of the subjects were found to be independent for performing their ADL and IADL. 95.8% of elderly were independent to perform their ADL and 87.3% were independent to perform IADL. 90% were able to use telephone, 81% were independent to do shopping, 89% were able to prepare food, 88% were able to perform housekeeping tasks, 89% were able to wash their clothes, 78% were able to go out independently., 94% of subjects were able to take responsibities of own medications and 90% were able to handle financial matters. Functional independence among elderly may be due to advancements in the field of medical science, which slows down the disease progression and decrease the severity of disability leading to better quality of life.

 

The results of the present study were also consistent with the findings of a similar study conducted to assess the Functional status and its predictor among elderly population in a hilly state of North India. A total of 400 community dwelling elderly persons residing in Shimla hills of North India were interviewed using valid and reliable functional assessment scales namely Katz ADL and Lawton and Brody IADL. The study revealed that the prevalence of ADL and IADL activity limitation was 5.5% (22/400) and 21.8% (87/400) respectively.⁷

 

ACKNOWLEDGEMENT:

Here we extend our sincere thanks to all elderly people who participated in the study.

 

CONFLICT OF INTEREST:

The authors declare no conflict of interest in the study

 

REFERENCE:

1.      United Nations, Department of Economic and Social Affairs, Population Division. World population ageing 2013. New York: United Nations. 2013 Feb 19.

2.      Tomas MT, Galan-Mercant A, Carnero EA, Fernandes B. Functional capacity and levels of physical activity in aging: a 3-year follow-up. Frontiers in medicine. 2018 Jan 9; 4:244.

3.      Freitas RS, Fernandes MH, Coqueiro RD, Júnior R, Matos W, Rocha SV, Brito TA. Functional capacity and associated factors in the elderly: a population study. Acta Paulista de Enfermagem. 2012; 25(6):933-9.

4.      Gupta P, Mani K, Rai SK, Nongkynrih B, Gupta SK. Functional disability among elderly persons in a rural area of Haryana. Indian journal of public health. 2014 Jan 1; 58(1):11.

5.      Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. The gerontologist. 1970 Mar 1; 10(1_Part_1):20-30.

6.      Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9:179-86

7.      Sharma D, Parashar A, Mazta SR. Functional status and its predictor among elderly population in a hilly state of North India. International Journal of Health & Allied Sciences. 2014 Jul 1; 3(3):159.

 

 

 

 

Received on 18.07.2019         Modified on 13.08.2019

Accepted on 08.09.2019      ©A&V Publications All right reserved