RESTING HAVEN AWAY FROM HOME: FILIPINO GERIATRIC CLIENTS

LIFEWORLD IN AN X-INSTITUTION FOR THE AGED

A Qualitative Research

SUBMITTED TO:
Mr. Romeo Q. Rivera Jr. RN, MSN

ABSTRACT

The qualitative study was intended to reveal the lived experience of geriatric clients

in an X-institution for the Aged. The phenomenological approach of inquiry was used to

seek the structures of consciousness as experienced from the first point of view. Semi-

structured interviews and observation were used to gather data. Open ended questions were

used to collect the lived experiences of geriatric clients in an X-institution for the Aged.

The data acquired during data collection involved the development of categories,

findings, conclusions, and connections from existing literature and integration of concepts.

Text analysis was used in the gathered data which resulted of geriatric clients lived

experiences in an X-institution for the Aged. The researchers used three themes in this

research, 1) Living with Loss, which refers to fact or the process of losing something or

someone significant. This is a feeling of grief, loneliness, hopelessness that indeed needs

more time to surpass and eventually return to the normal state of life. This is the most
difficult stage to suffer of every individual’s life, which absolutely needs more support from

family, loved ones and even friends to finally survived. Spiritual aspect of life is the most

appropriate to empower or enhance due to the fact that only God has the ultimate power to

annihilate and conquer any problems and challenges in life; 2) Living with Realization,

which refers to a state of being aware and conscious in a specific phenomenon or situation.

It is operationally defined as the state of things as they actually exist, as opposed to an

idealistic or notional idea of them; And 3) Living with Freedom, which refers to the power

or right to act, speak and think freely. It is also the state of being free, exemption or

immunity from unrestricted use of something, immunity also from duty or obligation which

every individual can only be experienced when he struggle and gain the highest level of

living. Whereas on the other hand, individual who reached the old stage of life which he is

not obliged to tackle task, responsibilities and obligations to justify and support his physical,

social, intellectual, psychological and most importantly, biological needs.

Introduction

"Geriatrics” is medical practice that addresses the complex needs of older patients

and emphasizes maintaining functional independence even in the presence of chronic

disease. It requires an interdisciplinary approach working with other physicians, nurses,

social workers, occupational therapists and family members, in order to provide

comprehensive care for these patients with multiple needs. It aims to promote health by

preventing and treating diseases and disabilities in older adults. There is no set age at which

patients may be under the care of a geriatrician, or physician who specializes in the care of
elderly people. Rather, this decision is determined by the individual patient’s needs, and the

availability of a specialist.

According to the US Census Bureau (He, Sengupta, Velkoff, and DeBarros, 2005),

the number of adults is increasing exponentially from 65 years old and above. Older

individuals will be seen at all levels of the health care system, and nurses must be addressed

their unique health care needs, keeping in mind that people living to an older age may have

one or more chronic conditions that may impact their ability to function. Older adults are a

unique population who experience specific changes in their bodies related to age.

According to Paul Beck, just as children are not simply tiny adults, the elderly are

not simply older versions of young adults. Like children, the elderly require special

approaches and an understanding of the physiologic, psychosocial, and physiologic impact

of aging.

The emphasis in providing health care to the elderly should be on maintaining

functional capabilities. Older citizens live in the community and are intellectually intact and

fully independent in their daily activities. Nevertheless, many elderly persons who are not

institutionalized report major activity limitations resulting from chronic conditions. These

limitations include basic activities of daily living (walking, bathing, dressing, using the

toilet, transferring from the bed to chair, eating going outside) and in home management

activities (shopping, chores, meals, handling, money).

Assisted living facilities are special homes for those elderly people who cannot

perform even their regular daily life chores, including going to the bathroom, clothing,
bathing, cooking, and eating without assistance. These homes bridge the gap between

interdependent living and living in a nursing home.

The reason for why an elderly would live in a care home because they are suffering

from a chronic condition that requires constant attention such as Alzheimer’s and Dementia,

lack of family care from them, family can’t care for them because of work, Alzheimer’s and

Dementia patients behavior changes and they almost become a completely different person,

so if a family member is available it may be to hard for them to see an elderly loved one in a

different state, some have no children to care for them. Some have children but they are

handicapped or in a poor health status and some want to live in residential living center to

be more independent from their children.

Resting haven away from home, literally it is a place where physiologic needs and

safety and security of a person are being attained or being given while that person is

practically away from that particular place where he/she has grown up, found friends and

built a family. Although the word “home” is such a broad and peculiar elucidation because

this is individually preferred, explored and felt. So to dwell in a home away from home,

away from loved ones and things one has lived on, not to mention bounded by strangers

whom are capable to care for them though, what will the impact of this to someone’s life

be? Does putting them in their places truly preserve their well-being as a person? Above all,

what will the perspective of these geriatric clients be whenever asked about staying in these

institutions?

When the day comes our aged parent can no longer function alone, the roles become

reversed-and parent becomes the child–left at the mercy of their children. To care properly
for elderly patients, you need to be professional yet compassionate, knowledgeable yet

flexible. It is not a job everyone can perform, yet it is a rewarding job for those who choose

it as their career. While it can be both physically and emotionally demanding, you can do

certain things to make caring for the elderly easier for both of you.

Research Design

The study pertaining to the geriatric client’s lifeworld in an x-institution for the

aged is a qualitative research and the researchers specifically used the phenomenological

type of research design.

Qualitative research is a subjective form of research that relies on analysis of

controlled observations of the researcher. This type of research yields extensive narrative

data, which include detailed descriptions of what has been observed. It is also an elastic

and flexible research technique which is used to gain insight into the underlying issues

surrounding a research problem by gathering non statistical feedback and opinions

rooted in people’s feelings, attitudes, motivations, values, and perceptions, often from

small samples.

Qualitative research is used to gain insight into people’s attitudes, behaviours,

value systems, concerns, motivations, aspirations, culture or lifestyles. Focus groups, in-

depth interviews, content analysis, ethnography, evaluation and semiotics are among the
many formal approaches that are used, but qualitative research also involves the analysis

of any unstructured material.

Phenomenological, as this study is, deals with the phenomenon’s nature and

meanings. This type of research design discovers the meaning of the participants’ life

experiences, given the perception of a particular situation. This type of study is useful

when a phenomenon of interest is poorly conceptualized. Thus, it usually deals with such

topics as the meaning of life for people suffering from chronic illnesses, those in stress, or

those who have lost their loved ones.

The main data source in phenomenological research is in-depth conversations,

with researchers and informants as full co-participants. The research study is composed

of four steps. These include bracketing, intuiting, analyzing, and describing (Salustiano,

2009). The goal of qualitative phenomenological research is to describe a “lived

experience” of a phenomenon. As this is a qualitative analysis of narrative data, methods

to analyze its data must be quite different from more traditional or qualitative methods of

research (Waters, 2005).

Research Findings

The data that were obtained in the data collection ended up with three major themes

arising from the geriatrics lifeworld inside the X-institution for the aged: (1) Living with

Losses, (2) Living with Reality and (3) Living with Freedom.

Five (5) categories arise from the first major themes, “Living with Losses.” These

included (1) Loss of Self-Worth, (2) Loss of Roles, (3) Loss of Hope, (4) Loss of Realistic

Expectations, and (5) Loss of Loved Ones. Five (5) categories belong to the second major
theme, “Living with Reality.” These included (1) Realization of Belongingness, (2)

Realization of Emptiness, (3) Realization of Desolation, (4) Realization of Being

Unimportant, and (5) Realization of Inferiority. Whereas, five (5) categories branched out

the third major theme which is “Living with Freedom.” These included (1) Freedom from

Guilt of being a Burden, (2) Freedom from Abuse and Danger, (3) Freedom from Boredom

and Isolation, (4) Freedom to Discover One’s Passion, and (5) Freedom from Life’s

Problem and Responsibilities.

Discussion

Aging has been defined as a universal, internally predictable biologic process

following maturity. It is characterized by changes accumulated overtime, that increase

susceptibility to disease and ultimately leads to death. Physiologically, aging in the absence

of disease involves a steady decline in the functional reserve of organ system and

homeostatic controls, especially when a person is under stress. In addition to disease,

nutritional status and other extrinsic factor such as environment, activity, medication and

depression are superimposed on the basic process of aging and create individual differences

in how one experiences aging.

Nurses who care for older adults and families from different cultural backgrounds

notice that family relationships vary within a cultural context. The availability of physical

and personal support from family members can facilitate the older person’s ability to

maintain independence, cope effectively with acute and chronic illnesses, remain functional

and productive despite disability and experience respectful death.

 Older adults from cultures that highly value independence and self-reliance may

refuse offers of assistance from their children, grandchildren and extended family members.

Depending on personal finances, these individuals may have planned carefully for their

aging in ways that rely on personal resources. They may seek assistance in a fee-for-service

basis from organizations that provide services and homes for the elderly but may refuse help

from relatives.

Though in Filipino culture and some older adults from culturally diverse

backgrounds who have given material and social support to children and grandchildren may

expect reciprocity during their aging years. In many Hispanic, Native American, Asian

American, Asian, Amish and Arabian, the cultural norm is to care for aging parents,

grandparents and extended family members.

In Filipino culture, the elder has the position of respect and is usually cared for at

home by the family. Should institutionalization occur, an elder may suffer feelings of

isolation, anguish and perhaps betrayal by loved ones.

Filipinos’ are great imitators is a common cliché, such is also observable in our ever

evolving culture. Beliefs and ideas, behavior and values are constantly changing. The old

idea of caring for elders until death may differ in today’s generation. Thus in order identify

new ideas and build up to date assessment and scientific knowledge regarding Filipino

geriatrics lifeworld in home for the aged the researchers interviewed and synch in with

geriatrics clients. Qualitative research was conducted through the bearing of a

phenomenological design where we are focused on descriptions of what people experience

and how it is that they experience what they experience.

Conclusion

All of the respondents, when being asked and interviewed by the researchers about

their lived experience inside the institution, some of them revealed that they are contented

and blissful enough, while few have uttered that they are miserable because they felt that

they are being rejected by their family, relatives and friends.

These are normal reactions of people who can easily adjust to the reality and to those

who abruptly lost their support system which indeed the most crucial experience an

individual may endure.

We therefore conclude that respondents inside the institution are still aiming, seeking

and begging for tender love and care to be rendered by the people they loved most

especially at the current situation they are facing nowadays.