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Predictors of Depression among Institutionalized Elderly Clients

in S€lected Elderly Facilities in CEBU' Philippines

DaisyR Palompo4R.N.,M.A.N.'Ph'D'*

Ruthl-. Ent€, RN.**

Jose B. BantugarL R.N.**

t Associate Dean of cebu Normal UniveNity, College ofNursing, c€bu City, Itilippines

** Faculty Memben ofthe Cebu Nomal University, College ofNursing, Cebu City, Philippines

/-\!14 I Jolmat of Nurs ng Sciefce Naresuan Univers ty Vo. 3 No 2

Background and Rationale

Aging is a phenomenol that everyone has togo through in life. The elderlypopulation is considered

vuherable to stress of different kinds. One common

srcreoqpe ol growing older is that there is a high chance

ofbecoming depressed. This st€rcorype has fostered

the exploration of depression as a natural aspect ofaging and how degession and ag€ are related. During

the past decade, therc have been significant research

flndings conceming depression among the aging

population and the aged.

Psychologists aim to fird answeN to numerous

questions concerning depression in the aging

population. This is such a major public health concem.

New research findings have suggested that depression

in late life occuls in the context of numerous social,

physical, and related disability problems (Meyers &Young, 1997).

A widespread belief is rhar depression is a

nahlal consequence ofaging but according to Meyers

& Youlg ( 1997) it is not. Although depr.ession in elderly

might be difficult to detemine because it is often masked

by physical condition, and dementia among others,

yet, there is a [eed to determine its gxistence among

Lhe elderly since !heJ need care which are approprjate

to their deyelopmental needs.

Depression affects the quality of life of the

elderly in otherways. It can substantially increase the

lil<elihood ofdeath liom ph)sical illnesses, increase

impairment from a medical disorder and impede its

improvement, while psychological treatment fr equently

rmproves the featment success rate for a variety ofmedical conditions. Unfteated depression can interfere

u/ith a patient's ability to follow the necessaly treahnent

regimen or to panicipale in a rehabiljrarion program.

Morcover, healthcare costs of elderly people with

r,4ay tu'gust 2009

significant symptoms ofdepressiol are roughly 50yo

higher than those who are not. Depr€ssion basically

alfects the total functioning ofapenon (NMIH,2005).

Elderly patients who areplaced in institutions

oi carc are prone to depression since they are mostly

away from their families or do not have families at all.

They are left to the care of stangers whom they

gradually learn to accept as their daily social groups

alrd sometimes they consider them as their family.

Th€re are factors that one should investigate e.g. those

lhat connjbute lo lhe development ofdepression among

the elderly who are institutionalized. In doing so,

careglven can provlde anticipatory care to these clients

who may develop depression. Therefore, these is a

need to determine the factors that predict the occunence

of depression among elderly clients in geriatric

institutions particularly in Cebu City, philippines thus

this study was undertaken.

Problem

The relationship between age, sex, educational

atiainment, marital status, self-esteem, social suppofi

and level ofdepression among elderly client admitted

in Home for the Aged in selected facilities in Cebu

City, Philippines including the variables that predicr

geriatric deprcssion.

M€thodology

A desc ptive - corelational design was used,

with simple correlational methods and multiple

regression analysis.

This study tookplace inHospicio de SarJose

rnBarili, Cebu, Philippines and Durano Foundation in

Danao, Cebu, Philippines. These institutions provided

permission and full support to the implementation ofthe study.

e1t6ltl'ltlIllln Fl ld Fli vraflslduul?fiq3 ilfr 3 "'t"L-^*^rrt1@

A researcher - adn-inistered questlonna[e was

utilized in the study. These included Part I peNonal

data such as age , highest educational attalnment,

madtal status ofthe respondent: Part II contained the

Self-estecm Scale, Part III contained the Berlin Social

Suppofi Scale and Part lV contained the Geriatric

Depression Scale.

Universal sampling was utilized in the study in

as much as only a limited numbs of elderly clients

were admitted at the Hospicio de San Jose (Barili) and

Durano Foundation (Danao) at the time of data

collection. Originally, only geriatdc clients within the

age range ofb0-70 $ere ident!lled. horlerer it ua"

noted that most of the clients in the two institutions

were above 70 years of age so the age lange was

increase from 60 to above 90 as long as the respondents

were admittedin eitherofthe twohomes for the aged;

able to talk and were oriented to time , person and

place. There were a total of 37 respondents.

Findings

Data showed that majority ofthe respondents

who were institutionalized were female, single and

have acquired only an elementary level of education.

This profile implies that single woman who do not have

immediate families of their own way have been left

behind by tbeir after siblings and have not acquired

stablejobs due to low educational qualihcations. This

profile also implies the signiflcance ofthe role offamily

members who are instntmental in tbe care of these

elderll [amil1 members in their home senings.

The mean age of the respondents was 76

indicating that they were on the later stage of

retirement. According to Duvall, at this stage, gedatric

clients are expected to be enjoying time for themselves

and reaping the fiilits of their long years of working.

Yet, it was observed that majority ofthe clients were

not receiving any retirenent benefits' on the comforts

ofliving with a family

The self-esteem measurement revealed that

najority ofthe respondents had moderate selfesteem'

None ofthem reported high self-esteem which meant

that the respondents had cefiain degree of insecurity in

unknown aspects- Meyers & Young and Eldercare

Online supporl this result that elderly clients expenence

a sense of low self-esteem due to depr€ssion These

respondents attdbuted a moderate level of self-esteem

because of the support provided by the institution's

caregivers and other volunteen who visit and take

care of them.

Most of the respondents reported adequate

social suppofi while a minorib/ showed highly adequate

suppofi. This was expected in these clients sinc€ most

olthem didnothave familymembers as evidenced by

their institutionalization. Some ofthem have reiatives

who visitthembutnot as oftenthe respondents would

want them. Moreover, most of the respondents are

single thus, support ftom others is seldom expected

The data revealed that majority of the

respondents have either mild to severe depression

This result is supported by Ostbye, Kristjansson, Hill,

Newman, Brouwer and McDowell (2005) who found

that elderly clients experience certain

levels ofdepression.

From among the independent variables that

conelated with level of depression, social support

showed a significant correlation at p: .00, r : 42.

with this result, the altemative h)?othesis that there is

a significant relationship between social support and

depression is accepted while the other altemative

hlpotheses rejected. This implies that social suppofi

has a significant influence on the level ofdepression

among geriatdc clients.

JoLrmat oi Nurs ng Sc ence NaresLran Uf versity Vol.3 No 2 A.4ay-August 2009

Conclusion

Based on the findings obtained, social support

is a necessary element in the upliftment of thewell-being ofan individual most specially for elderlyclients who are institutionalized. Furethermore,

institutionalized geriatdc cli€nts are found to have

higher tendencies to dev€lop depression specially those

who lack suppot from the caregivers and family

members.

R€commendation

From these conclusions the followingrcconmendations are presented:

l. Families ofpatients in geriatric institutions

should be involved in the care ofthe clients;

2. Gedatric institutions should provide

recreational activities that will help channel negative

emotlons ofclients thoughts positive means;

3. Caregivers should be trained to provide

empathic and sensitive and to geriatric clients.

4. A govemment - financed geriatric facility

should be esrablished in Cebu Ciry. Philippines to cater

to the growing number of decreased geriatric clients.

The Department of Healrh and Deparftnent of Social

Welfare and Development should intensify their

programs for geriatric health and social welfare

including those who are institutionalized.

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