PERCEIVED PSYCHO-SOCIAL NEEDS, QUALITY OF LIFE AND HEALTH-RELATED CHALLENGES AMONG THE ELDERLY IN A PERI-URBAN COMMUNITY IN IBADAN, NIGERIA

Abstract

The elderly face a broad range of medical, physical, psychological and social needs that require assistance and supervision on a temporary or permanent basis. This needs and health challenges often vary from community to community due to a number of factors. However, such concerns among the elderly in peri-urban setting, with a mixture of rural and urban characteristics, have not been fully investigated. This study was therefore designed to determine the perceived psycho-social needs, quality of life and health-related challenges experienced by the elderly in Apete, a peri-urban Ibadan community. The study was cross-sectional and employed a two-stage sampling technique to select 600 consenting elderly from the 12 neighborhood clusters and houses in the community. A semi-structured questionnaire used had questions on socio-demographic characteristics, perception, perceived needs, health-related challenges and typologies of social support received. These were measured using Quality of life-QOL (36); depression (30); General Health-GH (33); and dementia (8) scale. Scores of ≤15 and ≥15-36 on the QOL scale are categorized as high and low respectively. Depression scores of 0-9, >9-19 and >19-30 were classified as normal, mild and severe respectively. The GH scores of ≤15, >15-20 and >20-34 were categorized as lack of distress, moderate distress and severe distress respectively. Dementia scores were categorized 33 follows: 0-2 (intact functioning), 3-4 (mild impairment), 5-6 (moderate impairment) and 7-8 (severe Impairment). Data were analysed using descriptive statistic. Chi-square test and logistic regression at p=0.05. Age of respondents was 67.7±7.1 years; 56.2% were males; 78.1% are married; 28.7% had no formal education and 12.5% were living alone. Majority (86.2%) opined that home-based care was better for the elderly while most 90.1% had high QOL. Respondents' needs Included inadequate financial support (78.8%) and poor access to regular medical check-up (64.8%). Respondents with mild and severe depression were 27.7% and 4.7% respectively while moderate and severe dementias were 12.2% and 3.2%. Few (9.3%) had mild dementia: moderate and severe dementias were 0.2% and 0.3% respectively. Other reported health problems included insomnia (40.5%), hypertension (36.0%), diabeties (28.3%) and stroke (20.0%). Insomnia was significantly higher in females (46.0%) than males (36.2%). Health workers' unfriendly behaviour (93.3%) was a major concern among respondents. Among the married, more males (44.6%) than females (22.7%) received social support from their spouses. Children (91.3%) constituted respondents' main source of social support while support from the community was 15.5%. Significantly more females (93.9%) than males (89.3%) received social support from children. Respondents with formal education were more likely to have high QOL compared to those with informal education (OR: 2.5; CI: 1.2-5.0). Respondents living with other people were more likely to have high QOL compared to those living alone (OR: 2.2: Cl: 1.2-4.0). Access to adequate social support and provision of patient friendly health care services constituted the major needs of the elderly at Apete. There is need to re-orientate health workers on their behaviour towards the elderly and government should subsidise healthcare delivery to improve access to medical care.