A Study of Awareness of Health Problems of the Elderly with Reference to Mental Health

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1 OCTOBER 2009 DELHI PSYCHIATRY JOURNAL Vol. 12 No.2 Original Article A Study of Awareness of Health Problems of the Elderly with Reference to Mental Health S.C. Tiwari, Mamta Trichal, Betsy Mehrotra, Safia Najeeb Department of Geriatric Psychiatry, CSMM University, Lucknow, U.P. ABSTRACT Objective: To access the public awareness about elderly mental health problems method 750 subjects of above the age of 18 years of urban sector were selected through purposive sampling technique. Method: The study sample consisted, 862 subjects male & female above the age of 18 years. Out of the total population 1724 (study universe) were identified from Lucknow Municipal corporation. Only 862 (families residing elderly persons) were selected for study and rest 750 could be contacted due to their non-availability during visit of research team on working days. Self developed Performa were used for assessment of elderly problem. Results: Awareness was found very low about the elderly mental health problems (Dementia 0.8%, Delirium 0.4%, Delusional Disorder 1.6%, Insomnia 1%, Stroke 1.71 etc). Surprisingly few educated urban residents included in the study opined that the treatment of elderly problems is not necessary. Mostly the subjects (98.8%) were found unaware about the immunization of elderly and were also unaware about the appropriate diet of elderlies. Conclusion: The study strongly suggests need for psycho-education of the community particularly of the care givers. Study was carried out to sought out the suggestions of caregivers about the public awareness programmes. Keywords: Elderly, Mental Health Problems, Awareness. Introduction The population aging is one of the humanities greatest triumphs. The reduction in fertility level, reinforced by steady increased in the life expectancy has produced fundamental changes in the age structure of the ageing population. The older population of India, which was 56.7 million in 1991 is 72 million in 2001 and is expected to grow to 137 million by Studies indicates that socially deprived elderly are more vulnerable to psychiatric illness 1 over 81% of the elderly confessed of facing increasing stress and psychological problems of modern society. While 81% of the people of aged over 65 are reported to have at least one chronic health condition and 69% more than one. Inspite of such grievance of problem mostly the public is not aware of elderly problems to promote the community action professional bodies would need to initiate action for public awareness and education about the problems /needs of the elderlies. Several health risks related to unhealthy life style have been identified through epidemiological research in the last few decades. These include malnutrition, inadequate consumptions of fibers and fruit, physical inactivity, smoking and excess alcohol consumption. To provide the proper care to the elderlies. It is necessary for the care givers that they should have proper knowledge of adequate food, exercise diet and healthy behavioral patterns for older 2-4. The benefits associated with regular exercise and physical activity contribute to Delhi Psychiatry Journal 2009; 12:(2) Delhi Psychiatric Society 263

2 DELHI PSYCHIATRY JOURNAL Vol. 12 No.2 OCTOBER 2009 heal their independent life style, greatly improving the functional capacity and quality of life for older adults with disease states, special attention to nutrition is essential for recovery and control illness, with little or not need for medication 5,6. Therefore, a community based study was conducted in the urban sector of Lucknow City to identify the public awareness about the mental and physical elderly problems appropriate diet nutrition and to make a public awareness programme with the help of community. Material and Methods: The study sample comprised of 862 subjects of above the age of 18 years. Both male and female were included in the study. Out of the total adult population (1724) of two sectors of Bajrang Wali Ward identified from the voters list obtained from Lucknow Municipal Corporation, 862 (Families residing elderly persons) were selected for the study. Out of the total 862 targeted sample, only 750 could be contacted due to their non availability during research team visits on working days. A semi structure programme comprising of following schedule was administered Socio-demographic details. Schedule for assessment of awareness of elderly problems / nutrition / diet and exercise. Community expectation about the public awareness programme. Results: Table-1. Socio-Demographic Profile of the Subjects (N - 750) S.No. Number Percentage 1. Age N % Education Intermediate Graduate Post-Graduate Sex Male Female Marital status Married Single Widow/Widower/ Separated 5. Occupational Students House Wife Government Employee Private Employee Self Employed Type of Family Nuclear Joint Monthly Income < > Table-2. Awareness About the physical Problems of the elderly (750) S. Physical Aware by Aware by Unaware Total No. Problems name only name & symptom Special Senses Problems 1. Presbyopia Cataracts Glare Low Vision Glaucoma Dry eyes Presbycusis Delhi Psychiatry Journal 2009; 12:(2) Delhi Psychiatric Society

3 OCTOBER 2009 DELHI PSYCHIATRY JOURNAL Vol. 12 No.2 Table - 2 Contd... S. Physical Aware by Aware by Unaware Total No. Problem name only name & symptom Dental Problems 1. Dental Hygiene Gingivitis Dry Mouth Gastrointestinal Problems 1. Heart burn Peptic Ulcer Anal Fissure Hepatitis A Hepatitis B Hepatitis C Cirrhosis of Liver Cardiovascular Problems 1. Angina Pectoris Heart Failure Hypertension Sexual Problems 1. Prostatic Blood in Urine Vasinitis Male impotency Rheumatic and Orthopedic Problem 1. Osteoporosis Osteoarthritis Fungal Infection of the Toe nails 4. Gout Skin Problems Dry skin Herpes Zoster Fungal Infection Dental Problems 1. Dental Hygiene Gingivitis Dry Mouth Infections 1. HIV and Aids Pulmonary Problems 1. Chronic Bronchitis Asthma Pneumonia Tuberculosis Delhi Psychiatry Journal 2009; 12:(2) Delhi Psychiatric Society 265

4 DELHI PSYCHIATRY JOURNAL Vol. 12 No.2 OCTOBER 2009 Table - 2 Contd... S. Physical Aware by Aware by Unaware Total No. Problem name only name & symptom Nutrition 1. Cholesterol Weight Loss Obesity Hematologic Problem 1. Anemia Lymphoma Endocrine Problems 1. Hypothyroidism Blood Sugar Table - 3. Awareness about the Mental Health Problems of the elderly (N - 750) S. Mental Health Aware by Aware by Unaware Total No. Problems name only name Symptom 1. Dementia Delirium Depression Anxiety Disorder Post Traumatic Stress Disorder 6. Late life Delusional Disorder 7. Obsessive Compulsive Disorder 8. Personality Disorder Self neglect Tremors Stroke Insomnia Sleep-walking Fall and instability Results and Suggestions The community was formal largely unaware of Mental Health problems comparably of physical problems of elderly, as is evident from the Table-1 indicating overall very low awareness in the community about the problems of elderly, mostly the mental health problems and thus expelling the myth that people are not aware about mental illness of elderly. Mostly the subjects (46%) investigated, reported that Government hospital to be the best 266 Delhi Psychiatry Journal 2009; 12:(2) Delhi Psychiatric Society

5 OCTOBER 2009 DELHI PSYCHIATRY JOURNAL Vol. 12 No.2 Table - 4. Opinion about the Treatment (N-750) S. No. Place of Treatment Yes N % 1. Government Hospital Private Hospital Specialized Clinic Faith Healers No Treatment Should be given place of treatment, while few subjects (0.81) opined that treatment is not necessary of mental problems of elderlies. They were uncertain about the effectiveness of treatment.table-3 indicates that community is mostly unawar e about the immunization in graying population, very few people were found aware (1.2%) and of them very few were immunized their elderlies. While Table-4 indicates that generally the subjects were unaware about the appropriate diet/nutrition of elderly. Most of the subjects suggested guidelines for community education programme ensuring healthy ageing:- Table - 5. Awareness about the Diet of Elderly (N-750) S. No. Problem Mental Problems Increased Decreased Limited Total 1. Complex carbohydrates and fibers (roots, fruits, vegetable & beans) 2. Simple Carbohydrates (Sugar & Derivatives) 3. Calcium & Vitamin D (mild, curd cheese green vegetables) 4. Salt Intake Foods and antioxidant properties i.e. carrots, sweet potato s, spinach, tomato and orange 6. Additional supplementation of vitamin and micronutrients Table - 6. Awareness about the Immunization in Graying Population (N-750) S.No. N % 1. Aware Unaware (N-9) Receivers Immunized care % If Aware N % Yes No 1. Pneuimcoccocal Vaccine Influenza Tetanus/adult diphtheria (Td) Varicella Zoster (chikenpox) Delhi Psychiatry Journal 2009; 12:(2) Delhi Psychiatric Society 267

6 DELHI PSYCHIATRY JOURNAL Vol. 12 No.2 OCTOBER 2009 i. Details about mental/physical disease of elderlies should be given in appropriate words & easy language in booklets/pump lets. It should be displayed and provided house to house or be communicated through person to person communication. ii. To increase awareness the elderly problems due to decaying or a environment should be explained properly through knowledgeable / professional person. iii. Diet chart for elderlies should also be distributed through camps/personal meeting & at public gathering from where people can get easily ensuring healthy ageing will then be an objective of nutrition planning and dietary in termination at the individuals as well as societal levels. iv. Basic information should be available on phonic conversation through the professional/educator. v. In India vaccines are available but their wages is very hirited, because of back of awareness and the exorbitant cost. There is an urgent need of indigenous production of these vaccines to make them affordable for a population which needs health security interventions. vi. Camps and public awareness programmes should be organized time to time. vii. Family education regarding the care-giving should give through camps/in public gathering. Viii. Discussions should be on following topics- Topics: i. Physical activity of elderly ii. Regular Physical activity of elderly iii. Importance of Physical activity of elderly iv. Cooperation with care givers. v. Stress reduction for family caregivers: effects of adult day care use. vi. Self maintaining and instrumental activities of daily living of older people. On the basis of the above guide lines we can devise a strategy of educational programmes for older people as well as care givers using mass media and non formal communication channel continuing education programmes will be encouraged and supported. Creating mass awareness is therefore an important strategy for ensuring healthy ageing. It is noticed that in India, information, education and communication strategy using mass media, person to person communication, and group communication as in health education, school education and community education is almost non existent. References 1. Tiwari SC. Geriatric psychiatric morbidity in rural northern India : Implications for the future. Int Psychogeriatrics 2000; 12 : Hyer L, Blazer DG. Depressive symptoms. Impact and problems in long term care facilities. International J Behav Gerontology 1982; 1 : Baltimore Haley WE. The family care givers role in Alzheimer s disease pathway to understanding the experience. Johns Hopkins University Press, Arno PC, Levine C, Mammodt MM. The economic value of informal care giving. Health Affilicted (Millwood) 1999; 18 : Gwyther LP. Family issues in dementia. Finding a new normal. Neural Clinic 2000; 18 : Burton LC, Newsom IT, Schulz R et al. Preventive health behaviors among spousal caregivers. Preventive Med 1997; 26 : Delhi Psychiatry Journal 2009; 12:(2) Delhi Psychiatric Society

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