Nursing Journals Articles on Family Dynamics of the Independent Older Population
ISSN: 1130-8621
Enfermería Clínica is a peer-reviewed scientific journal that is a useful and necessary tool for nurses from the different areas of nursing (healthcare, administration, education and research) as well equally for healthcare professionals involved in caring for persons, families and the community. It is the only Spanish nursing journal that mainly publishes original research. Its objectives are to promote the dissemination of knowledge, promote the development of testify in care and contribute to the integration of research in clinical practice. These objective is pursued throughout the dissimilar sections that comprise the Journal: Original Manufactures and Short Original Articles, Reviews, Patient Intendance and Letters to the Editor. There is also an Show-Based Nursing department that includes two kinds of articles: comments about original manufactures of special interest written by experts, and bear witness synthesis articles based on bibliographic reviews.
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Objective To establish the perception of the older person as care recipients through the Cordial Older Family Nursing Model. This study used a qualitative phenomenological approach and in-depth interviews. A total of eighteen participants between 65 and 85 years sometime from the work area of the Community Health Center in Harjamukti, Depok. The finding of this study highlighted v focal themes: (1) the various types of complaints made by the older person, (2) their ability to conduct daily activities, (iii) the family unit support provided to them, (4) the grandchildren and in-laws who are existence treated similar the older person'south own children, and (five) the expectations of old age amongst the older person. Family support for the older person is proven to be a dominant theme among the participants. The evidence indicates older people acknowledge the positive impacts of the Cordial Older Family Nursing Model.
Keywords:
Perception of the older person
The Cordial Older Family Nursing Model
Geriatric family unit
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Introduction The development of scientific discipline and technology every bit well as the improvement in socio-economical status is correlated with the improvement in community wellness status, which increases life expectancy. This increase contributes to the rise in the number of the older person. Earth Health System (WHO) data from 2018 showed that approximately i million people reach the age of 60 each yr all around the world, of whom 80% live in developing countries. The United Nations (UN) estimates that the number of older persons aged over 60 years will double from 600 million to i.2 billion by 2025, then to two billion by 2050.1 As a country, which has experienced an improvement in the life expectancy of its citizens, Republic of indonesia has as well seen significant growth in the number of older persons. The results of the 2010 population census projections predict that the percent of Indonesian older person in 2035 will take reached 15% of the full population of the country.2 The increasing number of older people is an early sign of a shift in population structure in the earth, and in Indonesia, this volition create its challenges. 'Older person' has been defined as the chronological age at which someone has finally reached full maturity in terms of size and function but is as well showing signs of deterioration in several aspects, such as physically, psychologically, psychosocially and spiritually, which in itself raises health problems.3 Such bug experienced by the elderly affect their level of independence in carrying out daily activities. Kingston et al. (2017) state that there is a significant increment in the dependence of older people aged over 65. While male dependence on total care lasts for ii–4 years, the female older person just demands ane–iii years of care support. The majority of older person living in the customs.4 Those with a high level of dependence need family assistance to encounter their daily needs. The family, as the closest resource to the older people, is expected to facilitate and support them in their development phase, to maintain their wellness and well-being.five In reality, nevertheless, not all older people receive family unit attention and support in meeting their daily needs. The high level of dependency of the older person that is not provided by the willingness of the family triggers mistreatment, which is interpreted as intentional action resulting in danger or leading to the risk of serious damage directed at the older person, and the failure of caregivers to meet their basic needs.6 There are several types of mistreatment, namely: (one) concrete activity that causes hurting or injury; (ii) acts that trigger emotional distress or psychosocial danger; (iii) sexual violence; (four) financial exploitation; and (5) fail.six McDonald (2018) states that annually 8.2% (eight,275,670) of older person in Canada experience mistreatment, of which 2.ii% is in the form of physical abuse; 2.two% who experience concrete torture; one.6% who are sexually abused; 2.7% who are tortured emotionally; two.6% who face financial exploitation; and 1.ii% who written report the occurrence of neglect.seven Almost 12% of 118 older people in Nihon reported having been striking by caregivers who were as well their relatives,8 and nearly 54% reported having experienced at least one type of psychological abuse. The most common issue with psychological abuse is that older people is treated as if they are forgetful.eight Friedman et al.nine highlighted some factors related to the occurrence of mistreatment in the older person, which are sociodemographic factors, family and social factors, physical wellness, mental health, and disability. Thus, an increased level of dependency of the older person is associated with an increase in cases of mistreatment experienced by them. Investigations of mistreatment cases in Indonesia is notwithstanding express. Rekawati et al.ten (2007) conducted a trial of a model to discover abuse of the older person, which resulted in three assessment instrument formats, include (one) a health assessment instrument reviewed by health workers, (2) an interview instrument for the older person, and (3) an interview instrument for families. Research conducted by Rekawati (2014)xi shows that well-nigh half of 135 older people (49.6%) in Cimanggis, Depok, Due west Coffee had experienced mistreatment. Among this 49.half dozen%, 24.4% reported that they had received physical abuse, 45.2% financial exploitation, 74.eight% psychological abuse, and 43.7% reported the occurrence of neglect. Psychological mistreatment was the blazon of mistreatment that occurred the most, which necessitates special caregiving based on family unit approaches. The Cordial Older Family Nursing Model is i of the family-based interventions, which was developed by Rekawati (2014). The model considers the urgency of family support and family coping strategies, as well a reduction in the level of burden felt past the family unit when providing care support for the older person, and then that their health status tin can exist improved. The intervention requires iii activities to be properly executed to work, include the provision of information through training, suggestions, and counseling to families who are eager to provide support for the older person. The findings confirm the differences before and after the implementation of The Cordial Older Family Nursing Model were associated with mistreatment. The model that has been adult requires evaluation steps to monitor its sustainability and success rate. Therefore, nosotros are interested in examining the success charge per unit of the model by exploring the perceptions of the older person who received care support using the model. The study aims to explore perceptions of the older person as the care recipients from families who apply The Cordial Older Family unit Nursing Model. The report used a qualitative phenomenological arroyo to explore the experiences and to sympathise the meaning of the perceptions of the older person as the intendance recipients from families who employ The Cordial Older Family unit Nursing Model.12,xiii The study explored the experience of older people who received The Cordial Older Family Nursing Model of care from their family. We used several qualitative approaches for data collection, namely interview guidelines, phonation recorders, and notes. The in-depth interview method was chosen for the data drove since nosotros seek to explore the experience of families who implement The Cordial Older Family Nursing Model. A voice recorder was used to tape the interview of each participant, which lasted for about fifteen–25min. This study involved 18 participants, consisting of 13 women and v men in the age range of 65–85 years. The selection of the participants was made using the purposive sampling technique. The sampling criteria were as follows: (i) they were able to speak Bahasa (Indonesian language), (2) they were willing to exist a participant, and (3) they were older people who alive with their family unit who implemented The Cordial Older Family Nursing Model. The study used the Colaizzi method to analyze the data. This method consists of vii stages of analysis, include (1) training and re-reading of interview transcripts, (2) preparation of meaningful statements, (3) formulation of the significant of formulations, (four) determination and preparation of categories, sub-themes, and themes, (5) in-depth description of the research issue themes, (6) clarification of important structures of the phenomenon, and (7) validation of the research findings.12,14 The research passed the ethical review of the Faculty of Nursing, University of Indonesia. The finding of the study highlighted five focal themes, which are (1) diverse types of complaints by the older person, (2) the ability of the older person to behave daily activities, (three) family support for the older person, (4) grandchildren and in-laws who are treated like the older person's children, and (5) the expectations of old age amidst the older person. The theme "various types of complaints by the older person" is depicted equally the number of grievances reported by them; both physical and psychological issues were reported, which occurred due to the degenerative process. The concrete bug faced by the older person were digestive, respiratory, integumentary and musculoskeletal, and issues with circadian rhythm and cardiovascular systems. I description of a physical complaint was drawn from a statement made by the eighth participant: "…Well, that is what happens when yous are old. Any trouble might ascend such as physical or other aspects. She is already 75 years old…" (P8) Meanwhile, the psychosocial complaints identified in this study were fear, indifference to the diet, and feelings of sadness. The complaint is reflected by the third participant, who described his fear of travel due to his old historic period: "I am not going anywhere… simply stay at domicile… I am not even going to my sibling'due south house… grandma is old now…" (P3) This theme was found in the majority of participants' statements in the interviews. The older person was all the same able to perform their daily activities inside or exterior the house, despite the complaints reported. Some of the participants were still able to practice light housework, fulfill their needs independently, take care of other family members and carry out activities that they like in the house. The eighteenth participant described the activities he likes to do in the house: "Aye, she loves to plant flowers…" (P18)
Furthermore, the older person was also able to productively generate their income, participate in religious activities and practise outside the house. Those activities are reflected in the statement of one participant, who yet wanted to work, even if the family unit prohibited it:
"… Yes, my male parent wants to practice everything by himself; fifty-fifty though his son already told him to stop and balance, he would not listen. He does not like to rest and doing goose egg. He said that it is ameliorate to be productive…" (P2)
Family back up for the older person The theme "family support for the older person" is illustrated as the perceptions of the older person regarding the support given by their families. The older person felt that they had enough family back up in fulfilling their daily needs (instrumental), which is reflected in a argument made by the tertiary participant: "…Yes… all of them accept part in providing intendance support for me… she (the girl-in-law) cooks for me, washes my apparel… she does all of it…" (P3)
Families are also felt to support the older person in terms of health and treatment data (informational), which is reflected by the fifteenth participant:
"..My wife…my wife knows my routine, and she understands my schedule, when I should get to the doctor when I should register… she helps me a lot…" (P15)
The older person also acknowledged the financial support received from their families. They were provided coin by their sons-in-constabulary for everyday shopping and also given money by their grandchildren who worked. Fiscal support from the family is reflected in a argument fabricated past the first participant:
"…My grandchild, yes, she is like that to me.. she has got a chore now, thank god… when she has some money, she always gives part of information technology to me…" (P1)
The older person also appreciated the emotional support given by the family. The older they became, the more than support they received, including advice from the eldest children to stay away from stressful situations, the sense of security created by the family for them, the recreation opportunities provided, the sense of honey and affection, fun routine activities, and support in carrying out religious spiritual activities. The 7th participant reflected this emotional support:
"…ummm if I get angry, my child will requite me some advice to not be mad; she volition say "no need to be angry, mom, don't overthink, no demand to, use your money to purchase anything you want to eat… don't call back besides much"…" (P7)
Grandchildren and in-laws who are treated similar the older person'due south children The theme "grandchildren and in-laws who are treated like the older person'southward children" depicts the emotions and perception of the older person, who considers their grandchildren and in-police force as their children. One older person woman felt that her daughter-in-law loved her a great deal, which is reflected in the following statement: "…Specially my girl-in-law who is sabbatum behind me right now, she said to me "my female parent-in-law is my heaven"…" (P10)
The older person also felt a strong spiritual bond with their grandchildren. The bond is reflected in a statement from the fourteenth participant:
"…Yep, sometimes I miss them… because I take been with them since they were little, the connexion and bond never end…" (P14)
The closeness and affection that the older person felt from their grandchildren and sons- and daughters-in-police force created the same feelings as if they were their children. The third participant reinforced this theme:
"…Aye, my grandchild is like my child.. my daughter-in-law is similar my kid as well… I do non run into her as my daughter-in-law, but rather as my child…" (P3)
Expectations of old age amidst the older person The theme "expectations of former historic period amongst the older person" demonstrates their hopes for their family unit and themselves. The older person wanted their families to be successful and to be pleased to take care of them when they no longer able to conduct daily activities. She also wanted her family to obey worship and to always get forth with each other. The hope of the elderly for her family is reflected in a argument fabricated past the first participant: "…Yeah, I hope my grandchild will end school and accomplish success.. and share some of her fortunes with me…that is it… and her father to be able to take care of her teaching…"(P1)
The older person also hoped for longevity, to not cause any trouble to their family, and still to be able to assist other family members. The fifteenth participant illustrated this:
"…That is a wish… I hope all of the states can back up each other, to not exist troublesome… that is what I fearfulness the most.. for instance if I accept a stroke, it is very dangerous…" (P15)
Word Diverse types of complaints by the older person According to Miller (2012), the aging process experienced by the older person causes a functional decline in their bodies. Aging negatively affects the older person's hearing, vision and digestion; their urinary, cardiovascular and respiratory functions; and their mobility and safety, integumentation, thermoregulation, sleep and rest, and sexuality.3 This finding is in line with the physical complaints felt past the participants regarding their digestive, respiratory, integumentary, musculoskeletal, sleep and cardiovascular systems. Moreover, the older person also experiences psychosocial changes,3 i related trouble existence fear of falling. Lavedán et al. (2018)xv maintain that this fear causes the occurrence of several falling incidents in the older person. The feeling was besides experienced by the research participants, who described their fear of traveling due to their age. The older person participants in this study were notwithstanding able to conduct some regular activities within and outside the domicile, despite the physical or psychosocial complaints they suffered from. It is suggested that by performing daily activities alone, the older person reduce some of the signs and symptoms of aging, hence preventing the adventure of chronic diseases.xvi,17 Furthermore, this has been linked to an improvement in their quality of life.17 One of the physical activities carried out past the participants at dwelling was gardening. Dwelling house gardening tin improve their satisfaction in living life and reduce the risk of depression.18 On the other hand, the older person also carries out activities outside the dwelling house, such every bit generating their income, participating in religious activities, and exercising, which positively affected their health condition. The older person who is agile in physical, social and religious activities have a lower risk of the incidence of depression.19 Thus, activities carried out by the participants both inside and outside the home had positive impacts on their health, especially preventing the risk of depression. Older person people who live with their family accept a improve quality of life than those who live in nursing homes.20 Family unit support is of crucial importance for the elderly when facing their developmental stages, to improve their wellness and well-being.5 This study has uncovered several forms of support provided by families, namely instrumental, informational, financial and emotional. These results are in line with research conducted in rural areas of China, which found that family back up had a positive effect on the health status of the older person, equally is indicated past lower levels of mortality and incidences of cardiovascular disease, cocky-help and the ability to fulfill older person ADL independently.21 Financial support from the family is associated with decreased signs and symptoms of depression in the older person.22 Besides, emotional support as well has a positive impact on the older person with heavy dependence, particularly in terms of trust.23 Emotional support from the family unit tin likewise help the elderly to reduce the risk of loneliness.xix Furthermore, it was discovered in this study that family unit support had an impact on the health of the older person and their ability to engage in activities. Instrumental, informational, fiscal and emotional back up has successfully engendered enthusiasm so that the older person tin appoint in activities despite the physical and psychosocial issues experienced. Grandchildren and in-laws are members of the older person's family unit who play the part of caregivers at home. We constitute in the study that the older person regarded their grandchildren and in-laws as their children due to the support they received. These results are in line with research conducted in rural areas of Communist china, which found a skillful bond betwixt the older person and grandchildren of the start child, as indicated past instrumental, financial and emotional back up.24 The experience of grandchildren as caregivers of the older person is described as a satisfying and rewarding process. The grandchildren believe that they have provided their best support for the older person.25 Too, shut ties betwixt the older person and grandchildren occur because previously information technology was the older person who took intendance of their grandchildren. It was axiomatic from a study that older person people who were in one case the caregivers of their grandchildren tended to take a better level of psychological well-being.26 It was evident from this study that the relationship between the older person and their in-laws was well established. One older person adult female even considered the daughter-in-law who lived with her as her kid. The finding of this study is different from previous enquiry, which states that the older person and their daughters-in-law are ofttimes involved in conflicts, which means the old people are more than comfortable living with their daughters or sons-in-law.27 However, the results of other studies show that the older person relies more than on their daughters and daughters-in-law than their sons or sons-in-law for their care.28 The close relationship between the older person and their grandchildren and in-laws takes place because of the support given to each other, which creates a sense of belonging and dearest. This research also raises themes related to the older person's expectations in their onetime historic period. Hope is directed at the family and himself. Hope is negatively correlated with the incidence of stress in the older person, which means that the amend the expectations, the lower the level of stress felt by them.29 Therapy that optimizes the promise of the older person is also used in the psychological management of those who experience depression.thirty Positive expectations held past the older person about their families and themselves arise because of the good treatment received from the family unit. "Family back up for the older person" and "grandchildren and in-laws who are treated like the older person'southward children" are the two main themes which describe the most dominant perception expressed past all the research participants. The family caregivers in the study were those who implemented The Cordial Older Family unit Nursing Model. The focal themes arising from the study serve every bit signals that the older person sensed the positive impact of the model. The enquiry findings enable family caregivers to develop more comprehensive family-based interventions, which can optimize the health and well-being of the older person in the family unit. Hereafter studies could farther explore the perceptions of the older person, families and health personnel related to The Cordial Older Family Nursing Model then that these can subsequently be developed into a broader range of interventions. The authors declare no disharmonize of interest.
Acknowledgement
This work is supported by Center for Ageing Studies (CAS) Universitas Indonesia.
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Peer-review under responsibility of the scientific commission of the 2d International Nursing Scholar Congress (INSC 2018) of Faculty of Nursing, Universitas Indonesia. Full-text and the content of it is under responsibleness of authors of the article.
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Source: https://www.elsevier.es/en-revista-enfermeria-clinica-35-articulo-family-support-for-older-person-S113086211930155X
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