ABSTRACT
This pandemic caused by the COVID-19 has affected many people. Based on the World Health Organization, elderlies at care homes have experienced more problems as they are considered vulnerable to this risk.
This study employed a qualitative approach of research, where it utilized phenomenological method to explore the lived experience of elderly in care homes amid the pandemic. Specifically, it gathered information about the challenges encountered by the elderly in care homes during the pandemic; collated the themes which emerged from the experiences of elderlies and the role of positive psychology in the lives of elderlies as they overcome their life challenges. Through a self-constructed interview guide, the researcher of this study carried out an in-depth interview with 7 elderlies living in care home facilities in the province of Batangas. In this conduct, 9 themes emerged. These themes were Contentment, Satisfaction, Need for Love and Sense of Belongingness, Need for Social Interactions, Worry for One’s Health and Death, Anxiety Brought by the Pandemic, Spirituality, Overcoming Challenges Being Encountered, and Improved Quality of Life.
Hence, the elderly people living in care homes are mostly stable in their emotional aspects due to the good handling of the care home’s staff and caregivers. Generally, the experiences of elderly people make them understand the meaning of life and their limitations. Furthermore, it was also emphasized that their health is the most important. Positive psychology also affects their way of life as they face more challenges. This study intended to provide the elderlies with more opportunities to enjoy their life through more open communication with their families and to integrating positive psychology into every program for the elderly in care homes.
Keywords: Care home, Elderlies, Quarantined, Pandemic, COVID-19
INTRODUCTION
Population aging is considered a global phenomenon. Worldwide, there were 703 million persons aged 65 years or over in 2019. This number is projected to double to 1.5 billion by 2050 (United Nations, Department of Economic and Social Affairs, 2019).
As of 2015, the National Institute on Aging stated that about 4.7 million senior citizens are utilizing home-health care, 730 thousand were in assisted living facilities and 1.4 million were in skilled nursing facilities. Around the world, there are about 16 thousand nursing homes nationwide with 1.8 million beds (Neufeld, 2017). In the Philippines, it has recorded over 100 million total populations, where 7.5 million or 7.5 percent of those are Filipinos aging from 60 and beyond. As their number of populations increases, their lives become more difficult. Knowing the fact that most elderly people are already unemployed since they are on their retirement age and added on this is their health problems that come along during this period. There is a need for more support, from their families and the government (Philippine Statistics Authority or PSA (2015).
Filipinos are known to be family-oriented. They have very strong family ties. They value family above anything else (Goyala, 2019). This value keeps them together that even their elderlies live with them. However, in some families, they find problems on who is going to take care of them when they leave home for work. Although most Filipinos wanted to keep this tradition, some just cannot keep their loved ones due to some reasons, and therefore elderly abandonment in the Philippines exist. More than one and a half million elderly Filipinos have been abandoned due to several reasons. Because of the existing problems in the society, and mostly more on the lack of having the right conscience, Filipinos have no intention to sacrifice family but when times get rough, older family members can be compromised (Utzurrum, 2015).
Care homes are residential and nursing facilities that provide a wide range of care for people of old age when their families or loved ones can no longer give enough day-to-day assistance and support to them. In the western countries, especially in the western part of the world, they see nursing homes as a great option for elderly care for it provides a home-like environment, monitors the dietary and medical needs of its residents as well as activities to ensure active and engaged people. The historical view of care homes as isolated communities is fading, with a new strong focus on offering person-centered care for residents that keeps them integrated with their community (Donalson, Johnstone, 2018).
However, here in the Philippines, facilities like care homes are not being taken as a strong option for their dearest family member. While more and more people are now turning to nursing homes to look after their elderly relatives, however, the close family-ties tradition of Filipinos has prevented some from doing so (Abad, 2016). In addition, considering the socio-economic status of most Filipinos, others might just settle to support their elder family member by themselves than admit them to a care home, even if it means compromising the quality and quantity of support and care the family member is receiving. Meanwhile, on the point of view of some elderly people, since most elderly people are into traditions and cultures, they might also not consider being admitted to a care home. They are aware that they are in the latter part of their lives and wanted to spend more time with the people they love.
The COVID-19 pandemic has brought unexpected challenges and a disparate threat to humanity, specifically on old adult’s lives, relationships, and well-being. With the spread of this virus and its impacts on human health, no one can tell how long this pandemic will last and its long-term effect on older adults living in a restricted environment (Adhikari et al., 2020). As of today, the lack of information available within the literature necessitated the importance to negate the effects of the COVID-19 pandemic which impacts negatively on care home residents and the higher mortality rates for older adults (United Nations, 2020).
The novel Coronavirus Disease (COVID-19) pandemic is a global humanitarian crisis. The virus was believed to have entered the Philippines by a 38-year old woman who arrived from Wuhan City, China, which was a confirmed case of COVID-19 dated January 30, 2020. After two days, the Philippines recorded the first death outside China on February 01, 2020. According to the Department of Health, (DOH) the Philippines has recorded 51,482 covid19 active cases As of October 8, 2020, with a total of 331,869 cumulative number of confirmed cases. The mortality rate in the age group 60 to 69 years is 3.6% which can increase up to 18% at 80 years and above. The World Health Organization in its guidelines has endorsed strict social isolation in the senior population to control the deaths, especially in heavily affected countries. Due to high vulnerability, fear, panic, adjustment disorders, depression, chronic stress, insomnia, and anxiety in the seniors and their families also increases (Department of Health 2020).
The threats of Covid19 have a significant psychosocial impact. Misinformation and uncertainty give rise to mass emotional distress. The elderlies are especially susceptible to its psychological effects. As of today, one study focused on elderly mental health during these times of pandemic. It attempted to seek answers to the bio-psychological effects of social isolation of the elderly as a “serious public health concern. The study considered social distancing, as a major strategy to fight COVID‐19, as one major cause of loneliness, mainly in nursing‐care or old‐age homes. It pointed that social distancing or social isolation is an independent risk factor for depression, anxiety disorders, and even suicide. In this scenario, social connectedness plays a vital role during the public health breakdown, especially when “ageism” becomes a factor for stigmatization in this disregarded population. In this vulnerable population of elders, most of them are not engaged in social networks and even technology. Due to old age, they have a lowered cognitive ability which causes them to panic and makes it difficult for them to follow the precautions of distancing and hygiene. Moreover, it was concluded in this study that discrimination and lack of health care utilization are other factors contributing to their poor care during the COVID‐19 outbreak. Substantial stress generated by receiving so much information can lead to paranoia and healthcare-related uncertainty are important factors to consider in taking care of the elderly during this time (Banerjee, 2020).
In addition to the article of Banerjee (2020), he stated that mental health is the cornerstone of public health, specifically to the elderly. Mental cure is as important as a viral cure, as the global panic only increases the spread of the threat. Based on the lessons learned from SARS, it has been proven that regular counseling sessions, healthy contact with family, relevant and updated information, caring for the general medical and psychological needs, and respecting their personal space and dignity are significant components of mental health care in the elderly. This merits sensitization at all levels for early detection of mental health care needs and plan appropriate interventions.
Therefore, the primary goal of this phenomenological study is to explore the lived experiences of elderlies in an aged care home during the COVID-19 pandemic, especially their perspective on how it has impacted their daily routine, relationships, and overall well-being. Specifically, this study aims to investigate on life experiences of elderly people in care homes amidst the pandemic. The researcher will focus on determining the challenges encountered by the elderlies as they face the pandemic and the role of positive psychology in facing these struggles. In-depth interviews and observation will be used to gather the necessary data to address the goals of this study.
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