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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.
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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.
References
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