A Descriptive Study to Assess the Awareness and Usage of Assistive Devices for Mobility and Self Care among Elderly Residing in Selected community area of Kurali (Punjab)

 

Ms. Monika Thakur1, Dr. Raman kalia2, Mrs. Manpreet kaur3, Mrs. Shaweta Sharma4

1M Sc. Nursing Student, Saraswati Nursing Institute, Dhianpura

2Principal, Saraswati Nursing Institute, Dhianpura

3Lecturer, Medical Surgical Nursing, Saraswati Nursing Institute, Dhianpura

4Assistant Professor, Medical Surgical Nursing, Saraswati Nursing Institute, Dhianpura

*Corresponding Author Email: monikathakur89884@gmail.com

 

ABSTRACT:

As people get older, two major challenges impact on their ability to engage in everyday task. The first is a gradual decline in hearing, vision and mobility. Second challenge is a higher probability which increases with age of having one or more chronic disease such as arthritis, cataract and heart disease. In many cases the impact of impairment on doing everyday task can be overcome and reduced. Assistive devices are equipments that help a person with difficulty in performing a task, such as Canes, Crutches and Walkers can be used to increase a patient’s base of support, improve balance and increase activity and dependence. According to United Nations (2011), the share of India’s population ages 60 and older is projected to climb from 8 Percentage in 2010 to 19 Percentage in 2050. It is assumed that with rising number of elderly their age related problems will also be raised such as disabilities and other health conditions. The assistive devices for mobility and self care can make its use to sustain their independence in day to day activities and keeping with a view of this the following study was conducted. The Objectives of the study was to assess the awareness and usage of assistive devices for mobility and self care among elderly. To find out the association between awareness and usage of assistive devices for mobility and self care among elderly. Methods: A non-experimental descriptive design was used to assess the awareness and usage of assistive devices for mobility and self care among elderly and to find out the association between awareness and usage of assistive devices. A convenient sampling technique was used to select 200 study subjects. The data was collected through structured interview schedule to assess the awareness regarding the use of assistive devices and Likert scale to assess the usage of Assistive devices. Result: The result of present study revealed that 77% of the study subjects were having good awareness regarding the use of assistive devices whereas 23% of the study subjects were having average awareness regarding the use of assistive devices, 42% subjects sometimes use assistive device, 32% subjects frequently use assistive devices where as 26% of study subjects always use some assistive device while performing daily living activities. The most commonly use assistive devices were Magnifying glasses (76.5%) and commode chair (71.5%). The finding indicated that, there were no significant association between awareness and usage of assistive devices. The majority of them were aware about the use of Assistive devices but minimal usage was reported among them.

 

KEYWORDS: Assistive devices, Elderly, Awareness, Activity of daily living.

 

 


INTRODUCTION:

India has more than 76 million people above the age of 60 (years). Today, India is home to one out of every 10 senior citizens of the world. Their number is expected to swell to nearly 200 million by 2030 and 326 million in 20501.Disability is usually defined in terms of restriction in the ability to perform activity of daily living or the inability to function independently in term of basic activity of daily living with increasing age cum increased likelihood of disability2.

 

One of the intriguing aspects of recent decline in elderly disability is the increased use of disability related equipment or assistive devices. Devices and other environmental accommodations may enhance the ability of the person to accomplish a task, for example, a walker or cane to assist in moving around the home, or may reduce the physical requirements of the task, for example, adding environmental features such as railings or grab bars or moving to a more accommodative setting. Assistive devices (ADs) can help individuals with disabilities compensate for lost functions, increase their independence, develop their potential, and thus enhance their quality of life. Disability determined not simply by physical limitations, but by the social and physical environment of the individual. Disability may be defined as the inability to perform any accustomed or socially defined role without accommodation, either in the form of assistive devices or equipment or in the form of help from another person.3

 

Devices also may be used either independently or with help from another person and may either resolve difficulty in performing the task or reduce it, with the latter being more common (Verbrugge, Rennert, and Madans 1997). Studies using measures of global difficulty over multiple tasks have found that assistive devices may be more effective than personal assistance in reducing or eliminating disability (Verbrugge, Rennert, and Madans 1997; Agree 1999). On the other hand, Agree and Freedman (2003) found that for specific tasks, persons who used assistive devices without help were less likely to report a desire for personal assistance, even though they reported as much or more residual difficulty when using devices than did persons using assistance only.4

 

Assistive devices can be prescribed to broaden the base of support, improve balance and stability, or redistribute weight from the lower limbs to help alleviate joint pain or compensate for weakness or injury.

 

The goals of assistive device use are to improve independent mobility, reduce disability, delay functional decline, and decrease the burden of care. Elderly using assistive devices have reported improved confidence and feelings of safety, resulting in increased activity levels and independence5.

 

It is important to understand and gain an insight into the activities of older people and to investigate activities they are engaged in throughout their everyday living. It is believed that for older people to continue living safely in the community, they need to be independent in personal and instrumental activities of daily living like bathing, cleaning, walking etc.Use of assistive technology improves the mobility, reduces the disability and also decreases the burden of care providers. The elderly using assistive devices have improved confidence and feeling of safety which result in increased activity level and independence6.

 

A number of factors argue for the need to better understand the upward trend in device use and its implications for the growing older population. Research provides evidence that assistive devices may substitute for human assistance under some circumstances, although the full scope and implications of such substitution is not yet known. Nevertheless, if equipment use reduces or removes the need for help from other persons, it may reduce the demands of disability care on both families and public programs and increase independence and quality of life for elders with disabilities7.Assistive devices are the supporting devices used by persons with disabilities in improving their quality of life in terms of mobility, communication and for performing their daily activities. There are wide ranges of devices available to meet the needs of persons with disabilities. By the use of these aids peoples with disabilities become independent and their participation in the society increases.8

 

Having difficulty performing basic self-care and mobility activities (or activities of daily living) is common in late life. In 2011, more than one quarter of community-dwelling older adults reported limitation in performing one or more self-care or mobility activities. The most prevalent limitation is walking, followed by getting out of bed or a chair, bathing or showering, dressing, using the toilet, and eating. Not only does the proportion of older adults with such limitations increase with age but older adults are also likely to experience an increasing number of limitations over time.9   

 

NEED OF THE STUDY:

Ageing is a slow process that refers to the impact of passage of time on structure and function of different system of body. Ageing process is a biological reality which has its own dynamics, largely beyond human control. However, it is also subject to the construction by which each society makes sense of old age. The age of 55 or 60 years is said to be the beginning of the old age.10

 

It is suggested that basic activities of daily living and instrumental activity of daily living measurement determines how well older people perform in everyday activities For Example; an age related effect on the human body is the decline in the muscular strength and posture. Prolonged sitting and standing creates mechanical stress to joints and muscles. A solution to this problem is the use of an assisting device like adjustable chair, which can relieve strain and stress placed on the neck and back.11

 

One of the intriguing aspects of recent declines in elderly disability is the increased use of disability-related equipment, or assistive devices. Several studies using different data sources have found declines in the overall disability rate among older Americans, with larger decreases independent living activities, such as meal preparation and shopping, typically associated with lower levels of disability (Spillman 2004). Consistent evidence found across several national surveys of smaller declines in the mid to late 1990s in help with personal care activities, such as bathing and toileting that are associated with more severe disability (Freedman et al. 2004). Bathing was an upward trend in the prevalence of equipment use associated with a downward trend in the prevalence of help (Freedman et al. 2004; Spillman 2004). 12

 

Assistive devices can be prescribed to broaden the base of support, improve balance and stability, or redistribute weight from the lower limbs to help alleviate joint pain or compensate for weakness or injury. The goals of assistive device use are to improve independent mobility, reduce disability, delay functional decline, and decrease the burden of care. Elderly using assistive devices have reported improved confidence and feelings of safety, resulting in increased activity levels and independence. 13

 

Increasing age and increasing disability has led to a negative image of ageing. Some gerontologists have introduced the term ‘Successful aging, emphasizing the point that not all aging is negative. This however has led to the possibility of stigmatizing older adult who have a disability. To avoid this problem, kennedy and Minkler (1998) argue for a dialectical vision of aging where in both able- bodies and disable bodies are all part of ageing.14

 

Most persons are not instructed on the proper use of their cane, and up to 70 per cent of canes are faulty, damaged, or the wrong height.Studies have shown that most patients obtained their assistive device on their own or on the advice of family or friends. Only about one-third of patients obtained their device through a medical professional, and only 20 per cent received education on how to use it.15

While working in hospital and community posting investigator observed that most of the people with assistive devices have never been instructed on the proper use of devices and often have devices that are inappropriate, damaged or are of incorrect height. Through extensive literature review and investigators experience, the investigator has strong desire to conduct the study to improve the quality of life of elderly and improve their activities of daily living.

 

MATERIAL AND METHODS:

A Non-Experimental, Quantitative research approach and descriptive research design was adopted in the present study to assess the awareness and usage of Assistive devices among elderly residing in Dhianpura, Goshlan, Chatamla and chatamli ,Community areas of Kurali. Convenience sampling technique was used to collect the data. The population for this study were all the elderly living in community areas of Kurali. The sample size for the present study was 200.Structured interview schedule was used to assess the awareness regarding the use of assistive devices and Likert scale was used to assess the usage of Assistive devices comprises of three parts.

 

Part A:

Socio demographic profile sheet includes: Age, Gender, Marital status, Educational status, Type of family, present employment status, monthly income of elderly and assistive device presently used by the subject.

 

Part B:

Consisted of 20 items. Each item contained two options yes or no. The correct response was scored as one and incorrect response was scored as zero. The total score was 20.

 

Part C:

Likert scale. It consists of 25 items and each item has 4 statements which are scored as No use ( 0), sometime use (1), Frequently use ( 2) and Always use (3). Maximum score is 75 and minimum score is 0. Elderly achieving score Between 0- 25 has sometime used Assistive devices , 26-50 has frequently used assistive devices , 51-75 has always used assistive devices.

 

ETHICAL CONSIDERATION:

1     Written permission was taken from Principal, Saraswati Nursing Institute, Dhianpura, Kurali.

2     Written permission was taken from ethical clearance committee of the Saraswati Nursing Institute, Dhianpura.

3     Written permission was taken from sarpanch of community areas of Kurali, District Mohali.

4     Confidentiality and anonymity of the subjects was maintained throughout study.

 

RESULTS AND DISCUSSION:

Data were verified and analyzed using statistical package for social sciences (SPSS). The results were valuated using percentage value, mean, and standard deviation. Association between awareness and usage of assistive devices was calculated using Chi Square test.

 

Table 1: Score, frequency and percentage of awareness regarding use of Assistive devices. N=200

Category of Awareness

Score

Frequency

Percentage

Poor Awareness

0-6

0

0

Average Awareness

7-13

046

23%

Good Awareness

14-20

154

77%

 

The data presented in Table 1 depicts that Majority of subjects i.e. 77 % had good awareness regarding the use of assistive devices, whereas only 23% subjects had average awareness regarding the use of assistive devices.

 

Table 2:- Score, frequency and percentage of subjects as per the usage of assistive devices. N=200

Category of Usage

Score

Frequency

Percentage

Sometime

0-25

84

42

Frequently

26-50

64

32

Always

51-75

52

26

 

Table 2 depicts that 84 (42%) subjects sometimeused assistivedevices, 64 (32%) subjects frequently used assistive devices whereas 52 (26%) subjects always used assistive devices.


 

 

Figure 1:- shows percentage distribution of subjects as per their usage of Assistive Devices.

 

Table 3:- Association between awareness and usage of assistive devices among subjects.  N=200                                                     

 

Awareness regarding Assistive devices

Usage of assistive devices

Df

χ2

P value

Sometime  (n=84)

Frequently (n=64)

Always (n=52)

 

2

 

 

1.66

 

 

0.43

Average (n=46)

23

12

11

Good (n=154)

61

52

41

NS= Non Significant

 


Table 3 revealed the association between awareness and usage of assistive devices. Chi square test was applied to study this association. As per χ2 test, association between awareness and usage of assistive devices among subjects was found non- significant at level of 0.05. Hence there is no significant relationship between awareness and usage of assistive devices.

 

DISCUSSION:

The present study was conducted to assess the awareness and usage of assistive devices among elderly. The study was conducted on 200 study subjects residing in village Kurali, Punjab. The findings of the present study showed that the majority of subjects i.e. 77% subjects had Good awareness about the assistive devices while 42% subjects reported with sometime use of assistive devices.Similar findings were observed in the study conducted by Jasbirkaur, to assess the awareness and usage of Assistive devices among elderly. The objective of this study was to assess the awareness and usage of assistive devices among elderly. Checklist was used to collect the data. Results showed that majority of subjects i.e. 100% subjects had Good awareness about the assistive devices but only 33% were using it for activities of daily living. The majority of them were aware about devices but minimal usage was reported.

 

In the present study use of Toileting Aids for self care among subjects were commode chair 71.5%, anti slip mats 31%, Indian toilet 22%, bath bench 18.5 % and bed pan 12%. So the majority of subjects were using commode chair and Anti-slip mats as a toileting aids. Similar findings were observed in the reports of U.S. department of health and human services survey (1999) which depicted majority of subjects i.e. 54.5% were using commode chair,

 

37.1% were using seat for tub/showers, 17.2% were using grab bars, and 19.3% were using rubber mat in bathroom as a toileting aids for self care.

 

CONCLUSION:

From the present study it was concluded that maximum of the elderly were found to have good awareness. Most commonly used assistive devices were Magnifying glasses (76.5%) and commode chair (71.5%). The finding indicated that, there were no significant association between awareness and usage of assistive devices. Though majority of them were aware about various self-care devices but minimal usage was reported.

 

Elderly people using Assistive Devices are ready to function in a Self-care capacity when he or she practices activities that maintain life, health and well being. Self-care activities are influenced by the awareness and usage of Assistive devices. So education should be provided about Assistive devices so as to prevent complications and develop positive attitude regarding self-care.

 

REFERENCE:

1.       Alam, M.(2006).Ageing in India-Socio Economic and Health dimension, Academic foundation, New Delhi.

2.       Disability: definition; World health organization.

3.       Agree, EM and VA Freedman 2000. A comparability Assistive devices into community based long term care: An analysis of potential for substitution and supplementation, journal of ageing and health 12(3):426-450.

4.       Agree, EM and VA Freedman 2003. A comparison of Assistive technology and personal care in Alleviating disability and unmet need. The gerontologist 43(3): 335-344.

5.       Kaye HS, Kang T, Laplante MP. Mobility device use in the United States.Disability statistics report no 14.Wahington DC: National institute on disability and rehabilitation research, U.S Department of education:2000.

6.       Mobility devices statistics-united states-the university of California-disability statistics centre (2013-04-22)- http://www.disabled-world.com/disability/statistics/mobility-stats.

7.       Brenda CS. Assistive devices use among the elderly: trends, characteristics of users and implication for modelling. United states department of health and human services, 2005.

8.       U.S Department of health and human services. (2012).A profile of older Americans: 2012 retrieved from http://www.aoa.gov/aging_statistics/profile/2012.

9.       Pope and Tarlov (1991), the social model of disability, disability and society 28(7):1024-1020.doi:10.108.

10.     Verbrugge (1997). Environmental accommodation and successful aging. amj geriatric psychiatry.2006;14:2-5.

11.     Bateni H, Maki BE. Assistive devices for balance and mobility: benefits, demands, and adverse consequences. Arch Phys Med Rehabil. 2005; 86 (1):134–145.

12.     Salminen AL, Brandt A, Samuelsson K, Töytäri O, Malmivaara A. Mobility devices to promote activity and participation: a systematic review. J Rehabil Med. 2009; 41(9):697–706.

13.     Josh baker, gail b. assistive technology and older adults, the journal through care giving north dakota state university, 2013.

14.     Brenda cs. assistive devices use among the elderly: trends, characteristics of users & implication for modeling. united states department of health & human services,2005.

15.     Kennedy and Minkler (1998). Successful ageing , emphasizing the point that not all aging is negative.Journal of Gerontology: Social Sciences 56B:S206-S218.

 

 

Received on 10.08.2017       Modified on 30.10.2017

Accepted on 15.11.2017      ©A&V Publications All right reserved

Asian J. Nursing Education and Research. 2018; 8(3):357-361.  

DOI: 10.5958/2349-2996.2018.00072.1