The aim of this study is to explore an understanding of elderly people perspective on engaging factors leading to their admission into old age homes; their feelings, and challenges faced in daily living in institutional care. Purposive samplings was adopted and twelve residents from two old age homes in Kuala Lumpur and Selangor were interviewed using semi- structured interview questions. The collected data were analyzed using the thematic analysis approach.
Findings revealed that elderly people do not harbor feelings of anger and abandonment on their family’s decision but maintain good relationship with their family. They realized the best option for them is to be admitted into old age homes where they can be cared for by full-time trained personnel. Despite lack of individualized care and the feeling of loneliness, they were found to be understanding and tolerant with the services rendered by caregivers and are able to form attachment to their caregiver and attained a sense of belongingness at the homes. Overall findings indicated that elderly people are satisfied with their lives living apart from their own family and assisted by caregivers in old age homes.
Bowlby’s Attachment Theory states that a strong emotional and physical attachment to at least one primary caregiver is critical to personal development (Attachment Theory, n.d.). Brogaard (2015) said that the basis of this theory is emotional ties between people that are crucial to the mental, social and emotional development of a person. Attachment theory primarily focused on infant-caregiver relationship but the attachment process can continue through adulthood. The attachment behavioral system is the emotional bond that exist between a dependent and their caregiver where both feel secure when the other is within reach and responsive (Fraley, 2010). When they are eventually institutionalized, it could be natural for them to experience abandonment anxiety. This is the fear of being abandoned by their family because they may misunderstood that their family wants to get rid of them. Abandonment anxiety in turn gives rise to attachment anxiety whereby the elderly person constantly need attention from others and fear that their caregiver will leave them (Brogaard, 2015). Regardless of whether there’s any feeling of abandonment, generally, elderly people in old age homes will eventually come to term with the fact that they need to attach themselves to the caregivers both emotionally and physically in replacement of their family members.
Factors contributing to the admission into old age homes
1. Societal Changes
- Separate living arrangements and preference for privacy are the trend among young people nowadays
- Those with children accepted that their children and their spouses have to work to make a living and there are no caregiver at home.
- WHO (2005 as cited in Sulaiman, Baldry and Ruddock, n.d., p.131) stated that developing societies undergoing social, economic and cultural changes leave many families unable to care for their elderly family members and thus increased the demand for institutional care
2. Society’s modernization
- Findings from the present study revealed that elderly people in old age home do not felt animosity towards their children for sending them into old age homes
- The traditional Chinese philosophy of a child’s duty to care for aging parents could be neglected or weakening
3. Deteriorating health
- Consistent with signs of ageing, many elderly people are either stricken with chronic diseases such as stroke, diabetes, heart problems, osteoporosis, etc. which render them either with reduced mobility or in more serious cases, bed-ridden
- Family members, without proper training and lacking caregiving skills to handle sick elderlies will find it difficult to care for them at home. Most often, the spouse is also old and this makes it almost impossible for them to give proper caregiving to their aged and sickly other half
- They perceived the elderly parents will receive better care and attention from competent professional caregivers compared to family caregivers
- Most old age homes provide specialized services like palliative care, physiotherapy, bedsore management, wound dressing, hospital assistance and post-operative care
4. Changing family structure and lack of family caregiver
- The present study found some of the respondents are unmarried and that many of them have fewer children. A good number of them were working prior to their retirement and are self-sufficient.
- In today’s society, with better education and vocational training opportunities, people are holding better and higher paying jobs. Most people have saving plans and do not look towards relying on their children when they are old.
- When family structure downsizes, the consequence is lack of family members to provide caregiving duties to parents when they are old.
The feeling of elderly people staying in old age home
- Loneliness from lack of communication
- Death anxiety and life satisfaction
- Satisfaction with institution environment
The challenges faced by elderly people staying in the homes
- Sense of autonomy
- Lack of privacy
- Manpower constraint
- Attention-seeking behaviours
- Limited social and recreational activities
The findings from the present study may only represent the voice of a minority few elderly residents in old age homes. Nevertheless it could provide useful in-sights to the government, private sectors and charitable individuals regarding the psychological and emotional needs of elderly people who are either from the underprivileged category or being unfortunate enough to be living apart from their families. With this knowledge, sectors that are overseeing the welfare of senior citizens or parties concern about their well-being can formulate regulations and programs that will help to eliminate loneliness and isolation among senior citizens to help boost their self-worth in order for them to live the remaining days of their life as dignified human beings.