CHANGING PATTERN OF CARE FOR THE ELDERLY AND THE INTERVENTION OF MOONSHINE ELDER CARE CENTRE, BENIN CITY, EDO STATE CHAPTER ONE INTRODUCTION 1.1 BACKGROUND TO THE STUDY It is now commonplace to reflect on the fact that the Nigerian population, like the populations of Western developed countries is aging. Aging will continue because of the extension of life and the reduction of fertility (Troisi 2004). The ageing of world’s population is a crucial challenge for the 21st century. Population ageing affects individuals and nations and due to several factors which include decline in fertility, improvement in public health, increase in life expectancy and changes in pattern of care among the family structures and the decline in community services. Aging is the accumulation of changes in a person over time. More so, aging is a multidimensional process of physical, psychological and social change. (Bowen and Atwood 2004). Some dimensions of aging grow and expand over time, while others decline. Research shows that even in late life, potentials exist for physical, mental and social growth and development (Papalia, Sterns, Feldman, and Camp, 2002). According to the Economic and Social Commission for Asia and the Pacific, the number of older persons (people aged 60 and over) in Asia, as a whole, will more than double from 322 million in 2000 to about 705 million in 2025. Countries like Japan and Singapore will likely have the oldest population by 2030. Decline in fertility was brought about by more wide spread acceptability of family planning and changes in family structure while increase in life expectancy is attributed to improved medical care on support of the elderly was brought about by technological advancement (ESCAP 2001). According to a published U.S Bureau Bulletin of the Census and Database on Ageing in 1988, the world’s total population is growing at a rate of 1.7 percent per year. The population aged 60 years and above is increasing by 2.2 percent per year; and the number of persons aged 65 years and over, is rising by 2.8 percent annually. The bulletin shows further that every month, the net balance of the World’s older population (60 years and over) increases by 1.2 million persons. It is expected that this demographic pattern will continue. Troisi (2004) observed that already one out of every ten persons is now 60 years or above. By 2050, one out of five will be 60 years or older and by 2150, one out of three persons will be 60 years or older (Troisi 2004:354). Troisi also observed that the older population is ageing, that is, the oldest old (80 years or older) is the fastest growing segment – constituting 11 percent of the 60 years or older age group, is projected to grow to 19 percent by 2050. The number of centenarians is projected to increase 15fold from approximately 145,000 in 1999 to 2.2 million by 2050 (Troisi 2004:354). Even though population of the elderly is increasing in all countries of the world, up till the early 80‟s, the demographic transition was mostly viewed as a phenomenon of the developed countries (Sylvia, 2000; Troisi, 2004). But in fact as observed in the literature the great majority (two-third) of those over 60 years of age live in the developing world and that the proportion is increasing steadily and will reach nearly three-quarters by the 2030‟s (UNFPA and CBGS, 1999 cited by Sylvia, 2000:9). In Nigeria, the proportion of the aged population has been increasing. According to a research by (NPC) before Nigeria gained independence in 1960, there was a population census conducted in 1952/53. Since independence, the country had only conducted three successful population censuses in 1963, 1991 and 2006. The total number of persons aged 60 years and above in 1952/53 was 2,448,000. In 1963, 1991 and 2006 population census the total number of persons aged 60 years and above was 3,617,000 and 8,227,782 and 19,580,204 respectively (NPC 2003). This data shows that the population of the elderly has significantly increased and the issue of changing family structure and care provision for the elderly is one of such values, which is culturally rooted and esteemed but face with challenges in modern time. In many traditional African societies the family is charged with the responsibilities for the provision of support for the elderly and such support is provided voluntarily without any remuneration (Kosberg, 1992; Brown, 1999). The population of the elderly in the world is increasing rapidly (United Nations, 2004) and the rate of increase is higher in developing countries including Nigeria. Currently, Nigeria has the highest number of the elderly people in Africa estimated to be about 5.6% of the Nigeria population (NPC, 2008). With this increase in the growth of the aging population, the number of people that will need health care will undoubtedly increase. (Donatelle 2011) posited that in most curricula for health professionals, little or nothing is indicated about the care of the elderly showing absolute neglect in this area (Mclafferly and Morrison 2004) stated also that most health workers have very poor knowledge of mental health conditions which are common with the elderly and as such health workers come to service with deep seated, negative, diluted and superstitious belief about caring for the elderly. This lack of adequate knowledge and negative attitude towards the care of the elderly may result in serious problems in our society in the near future. The nuclear institution formed the bulwark of informal social welfare support to elders in Africa (Apt and Katila, 1994 in Ghana; Adamchak 1991, in Zimbabwe and TogonuBickersteth, 1987a, b 1988, 1989 in Nigeria). Unfortunately, with the SubSaharan African societies coming under various cultural influences and high death tolls of the youth by HIV/AIDS, the traditional institution that supported elderly care is highly threatened. The extended kinship support is gradually declining under the pressure of modernity. Economic woes and recession, coupled with governments‟ insensitivity in the region, also compounded the problems of the elderly as they have been largely neglected in various issues that affect them. Most African countries are inadequately prepared for the emerging challenges of the growing elderly population (United Nations, 1994). The extended families institution has generally become less effective in the support of the care for the elderly. To make things worse in this part of the continent, concurrently with the rising proportion of the elderly, is the weakening of the traditional safety nets (Ojewale 2013). A major challenge in the face of rising proportion of the elderly population, is the physiological and psychological care of the elderly, This research is therefore an attempt to understand the changing pattern of care for the elderly in Nigeria. The family cannot adequately meet the needs of the old persons in Nigeria, and the diminishing economic power has hindered the willing family member’s capability to provide care. Priorities are given to the needs of the members of the nuclear family – spouse and children – at the expense of older family members: parents or grandparent, care provided by the family has gradually decreased. But with changing social and economic configurations, older persons are most of the time left in the care of strangers i.e. people who are not properly trained to be caregivers, many of them uneducated, young and frustrated (Oyetunde and Ojewale 2013). This has led to the changing pattern of care and the social work intervention and services in modern society, this research work is to explore the social work intervention and the introduction of moonshine elder care Centre as a platform to bridge the gap of care for the elderly in Benin City, Edo State. 1.2 STATEMENT OF THE PROBLEM The need for Geriatric institutions is more than ever more urgent now in Nigeria because of the increasing number of aged people. It was estimated that by 2015, there will be 64.6 million aged in the world; this figure was expected to rise to 103 million in 2030 and by 2050, we should have over 205 million aged people (Mudiare, 2013). With increasing numbers of older people, especially in Africa, unfortunately the increase is taking place in a situation where the society is least prepared for challenges that older people are experiencing at present as the demand to meet their needs grows. The range of problems that older people in Africa are facing is constantly increasing as societies are locked up in conflicts, experience huge economic problems, natural disasters, diseases and deterioration in family relationships. In as much as these harrowing experiences, frustrating structural strains, the elderly are faced with the challenges of deteriorating health conditions, poor nutrition, poor housing, poor hygiene, lack of healthcare, elder abuse, social security, isolation, boredom, and dependence. At varying international fora, much concern has been expressed about the elderly, with profound suggestions made towards improving their conditions. These fora include the United Nations‟ First World Assembly on Ageing, in Vienna in 1982 (United Nations, 1982 cited in NPC, 2003); International Conference on Population and Development, 1994, and, Madrid International Plan on Ageing, 2002 (NPC, 2003). Given the economic difficulties in families, unemployment, urbanization and poverty, it is increasing difficult for grown up children to manage their own families of procreation as well as their aged parents thus putting the elderly at risk of abuse and neglect whether or not they live alone. Researchers continue to come up with different findings about the changing patterns of the care for the elderly especially in developed economies. Can the findings of those studies be replicated in emerging economies like Nigeria? In Nigeria, little or no empirical studies have been done to establish the changing pattern of care for the elderly and the intervention (Mudiare, 2013). 1.3 OBJECTIVES OF THE STUDY The broad objective of this study is to examine the changing patterns of the care for the elderly and social work intervention. The specific objectives are: 1. To examine the challenges encountered by the elderly in our society. 2. To examine the level of professional intervention by social workers and its contribution to care for the elderly. 3. To examine the role of social workers in elderly care centers. 4. To determine the importance of legislative enactment on policy for the Geriatric institutions. 1.4 RESEARCH QUESTIONS In line with the objectives of the study, the following research questions are raised: 1. What are the problems encountered by the aged in the society? 2. To what extent does moonshine elderly care center cater for the aged or elderly in our society? 3. To what extent will government social security and social protection benefit the elderly? 1.5 SIGNIFICANCE OF THE STUDY Having increased number of ageing population is an indicator of high survival rate occasioned by good health system and condition of living. At the family level, it is a pride in some communities in Nigeria to have their parents or relations ageing who are elders because of their roles in recounting past stories, customs, tradition and care for the children. On the other hand, they come to become liabilities to the families when they pose health problems requiring fund for treatment or constitute total economic burden on family and children. At the community or family level, elderly persons become liabilities when they are not contributing to the economy and much money has to be set aside for their health provision and other services. As a result of the poverty in the family level and government’s non provision for the ageing, a significant number engaged in alms and begging and other undignified practices to earn living. Older people constitute a part of society’s structure which has a role to play and has some needs that must be met. However, if those needs are not met such as engaging in activities, shelter, food, clothing, financial, isolation, health, sex, safety, love, affection, belongingness, respect, welfare, retirement, etc., they can constitute a problem to the society and thereby, affect other parts of the social structure. The most likely result is that, older people may depend on other parts of the structure for survival and create problems for the society, especially the family and the government. These practices were considered in the past as a taboo. The study therefore scrutinize the role of extended family in the care if the aged living in the respondents‟ area with a view to knowing the level of care and support available for them. The findings of this study provided information on the level of awareness of elderly, the introduction of elder care institution and services. It further provided information for care and support, types of occupation engaged in their challenges and means of addressing them. In addition, it provided useful basis upon which further studies can be made. The result will help to provide basic information for designing structures and programmes for the care of the elderly in the community. It will also provide evidence based information on graceful ageing. It will serve as a reference material to other researchers in the field of community health practice. Findings of the study will help in showing the level of knowledge and attitude of the care providers towards the care of the elderly and will help improve the decision making. The result will also help in building up knowledge base on the care of the elderly patients. Improving data base on elderly health nutrition and standard of living which will help for further research, advocacy, policy dialogue and programming. 1.6 AREA OF STUDY Moonshine eldercare Centre facility, which is located in Benin City, Edo State Nigeria. Between 1st and 2nd Ugbor, 12 Ezezobo longe street, GRA, Oka, Benin City. 1.7 DEFINITIONS OF CONCEPTS Pattern:Type of care given to the elderly Modernization:Refers to a model of a progressive transition from a pre-modern or traditional to a modern society or way of doing things. Care:The provision of what is necessary for the health, welfare, maintenance and protection of the elderly. Aged:Individuals from 60years and above Extended family:A family which can be extended beyond the nuclear family, it include the grandparents and other relatives. Nuclear family: A couple and their dependents children, regarded as a basic social unit.
CHANGING PATTERN OF CARE FOR THE ELDERLY AND THE INTERVENTION OF MOONSHINE ELDER CARE CENTRE, BENIN CITY, EDO STATE
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