Educational Gerontology

ISSN: 0360-1277 (Print) 1521-0472 (Online) Journal homepage: https://www.tandfonline.com/loi/uedg20

Who Says there is No Life After Abandonment? A

Grounded Theory on the Coping of Abandoned
Filipino Elderly in Nursing Homes

Allan B. de Guzman, Jeremy C. Lacorte, Andrea Keith G. Lacsamana, Mark

Lawrence M. Lagac, Jobel M. Laguador, Jazminn Jessica R. Lapid & Lyndcie
Miriele C. Lee

To cite this article: Allan B. de Guzman, Jeremy C. Lacorte, Andrea Keith G. Lacsamana, Mark
Lawrence M. Lagac, Jobel M. Laguador, Jazminn Jessica R. Lapid & Lyndcie Miriele C. Lee
(2012) Who Says there is No Life After Abandonment? A Grounded Theory on the Coping of
Abandoned Filipino Elderly in Nursing Homes, Educational Gerontology, 38:12, 890-901, DOI:
10.1080/03601277.2012.661329

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Educational Gerontology, 38: 890–901, 2012
Copyright # Taylor & Francis Group, LLC
ISSN: 0360-1277 print / 1521-0472 online
DOI: 10.1080/03601277.2012.661329

Who Says there is No Life After Abandonment? A

Grounded Theory on the Coping of Abandoned Filipino
Elderly in Nursing Homes

Allan B. de Guzman
College of Nursing, College of Education, The Graduate School and Research Cluster on
Cultural, Educational and Social Issues, University of Santo Tomas, Manila, The Philippines
Jeremy C. Lacorte, Andrea Keith G. Lacsamana, Mark Lawrence M. Lagac,
Jobel M. Laguador, Jazminn Jessica R. Lapid, and Lyndcie Miriele C. Lee
College of Nursing, University of Santo Tomas, Manila, The Philippines

Cases of abandoned elderly are increasing worldwide. By and large, this group struggles with the
sudden change in living arrangement as well as abandonment by their families. Consequently, many
elderly are forced into living in nursing homes for the remainder of their lives. Abandonment among
these elderly negatively affects how they view themselves, which is detrimental to their health and
well-being. Thus, exploring the feelings of elderly regarding their abandonment and how they cope
becomes a major concern in caring for them. Recognizing the dearth of literature, this grounded
theory study purported to describe sthe process by which these elderly cope with abandonment. A
total of 24 abandoned Filipino elderly respondents were purposively selected to take part in a
semistructured in-depth interview. Following the Glaserian approach, a four-part process emerged
to describe the layer of human experience under study. The R.O.P.E. to Cope Theory of Abandon-
ment describes how the elderly progress from the resisting, occupying, pondering, and embracing
phases toward successful coping. Understanding this process equips health care providers with
knowledge of appropriate interventions in the provision of holistic care to the elderly. Ultimately,
findings of this study will be helpful in assisting abandoned elderly individuals in their path to
achieving an improved quality of life and a happier perspective on it.

By and large, globalization has not only impacted the economic sphere of people, but the social
sphere as well (Harbison & Robinson, 2001). One scholar observed a change in family dynam-
ics: ‘‘Family loyalties are not what they used to be: family responsibilities are understood as less
binding than they were even a generation ago’’ (Krause, 1990, as cited by Wise, 2001, p. 563).
This is evidenced by the increasing incidence of abandonment of elderly in countries such as
Romania (Runcan, Hategan, Barbat, & Alexiu, 2010); Africa (Habte-Gabr, Blum, & Smith,
1987; HelpAge International—Africa Regional Development Centre & HelpAge Kenya,
2001); and Korea (Lee, Gibson, & Chaisson, 2011). Tatara and Kuzmeskus (1996, p. 2). for their

Address correspondence to Allan B. de Guzman, Research Cluster on Cultural, Educational and Social Issues,
University of Santo Tomas, Manila 1015, The Philippines. E-mail: abdeguzman@mnl.ust.edu.ph
 COPING WITH ABANDONMENT 891

part, defined abandonment as ‘‘the desertion of an elderly person by an individual who has
assumed responsibility for providing care for an elder, or by a person with physical custody
of an elder.’’ Such a growing trend is brought about by the increasing unavailability of adult
children (Zhan, Feng, & Luo, 2008) as a result of increasing urbanization and industrialization
(Wu, White, Cash, & Foster, 2009); changing employment patterns (Hessel & Keck, 2009); and
poor living conditions (Carlos, 1999), among others.
Some elderly individuals have been found abandoned in front of hospitals; others had less
fortune, left to fend for themselves on the streets (O’Connell et al., 2004; HelpAge
International—Africa Regional Development Centre & HelpAge Kenya, 2001). Further, a num-
ber of elderly resort to living in public housing, retirement homes, and nursing homes. Elderly
also live by utilizing in-home services and homesharing of granny flats and congregate housing
(Howe, 1985). The choice to move into a nursing home by the elderly is often done either
voluntarily or by recommendation of the government. As with all life transitions, the move to
a nursing home is a process of interacting biological, physical, psychological, and communicat-
ive events (Nussbaum, 1993). However, this event was found to be particularly stressful. It was
observed that many elderly people who relocate to a nursing home experience apprehension,
anxiety, loneliness, depression, insomnia, and at times, suicidal ideation (Keister, 2006; Melrose,
2004; Castle, 2001). The struggle of dealing with abandonment, coupled with the physiologic
and psychosocial difficulties resulting from the dramatic change in living environment, call
for greater coping skills on the part of the elderly individual.
Coping, as defined by Folkman and Lazarus (1984, p. 141). is a ‘‘constantly changing cog-
nitive and behavioral efforts to manage specific external and=or internal demands that are
appraised as taxing.’’ In relation to nursing practice, it is imperative that nurses are equipped
with the knowledge to deal with the elderly not only to address their needs in the physiologic
aspect, but in the totality of the person. Part of a nurses’ supportive functions is offering psycho-
social and emotional support to the elderly, assisting with transition and life review, enhancing
lifestyles and relationships, facilitating self-expression, and ensuring cultural sensitivity (Royal
College of Nursing [RCN], 2007). In line with this, nurses then play a vital role in aiding the
elderly person cope with the different situations he=she faces daily.
To date, there is a dearth of literature regarding abandoned elderly and how they cope. Thus,
this qualitative paper aims to describe the process by which institutionalized Filipino elderly
cope with their feelings of abandonment. As such, it will provide knowledge to assist nurses
and other health care professionals to employ appropriate interventions that will help these
individuals undergo the process properly and successfully.

METHODS

Design, Subjects, and Study Site

The grounded theory design was utilized in this qualitative study for the purpose of propounding
a model that will explore the process of coping by elderly clients who were abandoned in nurs-
ing homes. The goal of grounded theory is clearly related to explicating basic social processes
and patterns of interactions (Mitchell & Cody, 1993). From a structural symbolic interactionist
perspective, grounded theory methodology was selected because of its rigor in identifying social
892 A. B. DE GUZMAN ET AL.

processes and problems and conceptualization of a phenomenon that has not been well
developed (Glaser & Holton, 2004). In grounded theory, sampling is based not on a predeter-
mined number of subjects; instead, it is based upon theoretical concerns, such as saturation of
data, to enable theory development (Mottram, 2011).
A total of 24 (n ¼ 24) respondents from a government-funded institution for the elderly
in Metro Manila were purposively selected to participate in the study. All participants met the
following inclusion criteria: Filipino, at least 65 years old, residing in a nursing home, not visited
by family and relatives, mentally competent, and conversant.
The subjects were of ages 60–82 (
x ¼ 69), mostly separated=single=widowed, and were
Roman Catholics. In terms of length of stay in the nursing homes, the majority stayed for about
a year or more. Most of the respondents either voluntarily applied to live in the nursing home or
were brought there by social workers. Additionally, all visitors received by the respondents were
beyond family bonds: students, philanthropists, celebrities, and politicians.

Data Collection

To obtain an in-depth insight on the process of coping by elderly individuals abandoned in nurs-
ing homes, a two-part semistructured interview was chosen as the method of data collection.
The initial part of the interview utilized a robotfoto to obtain the demographic data of each
respondent. Information acquired includes age, gender, civil status, religion, province of origin,
name of the nursing home, years of residence in the nursing home, frequency of receiving visi-
tors, and relationship to visitors.
An aide memoir was then developed to allow for the disclosure of the process entailed in the
chosen layer of human experience. Questions included how the respondent viewed himself and
his relationships with family prior to residence in the nursing home; how he is affected by the
feeling of abandonment and how he copes with this; and how he views himself at present.
Face-to-face interviews lasted for a minimum of one hour to a maximum of two. The entire con-
versation was tape recorded and was then transcribed verbatim.

Procedure and Ethical Consideration

Approval to conduct the study was obtained from the local department of social welfare. All
respondents freely gave their consent to participate in the study after a thorough explanation
by the researchers. Consent was evidenced by a participant’s signature or thumb mark affixed
to an appropriate form. Further, personnel from each of the nursing homes were asked to bear
witness by countersigning the said form. Throughout the interview period, the researchers and
personnel secured the safety of all respondents in the study. Consideration was given to data
security, privacy, and confidentiality; therefore, pseudonyms are used when quoting from inter-
views (Reynolds, 2010). All audio recordings were made with the consent of the respondents.

Data Explication

Gathered data was scrutinized in a series of processes that were guided by the principles of
Glaserian grounded theory approach. This approach was employed because it allows the
 COPING WITH ABANDONMENT 893

emergence of categories (Kelle, 2005) from the grounded perspective; thus, this approach poses
a high degree of relevance to the area being studied (Turner, 1999). Eventually, following the
course of this analysis leads to the development of a theory that illustrates the process by which
institutionalized elderly cope with the feeling of abandonment.
Initially, tape-recorded interviews were transcribed and then translated to generate field texts.
Subsequently, manual coding was performed through the naı̈ve understanding of data, which
allowed identification of key words or significant statements related to the layer of experience
under study. After which, data scrutiny was employed through the use of a repertory grid
wherein data were clustered into categories. These categories were then reduced further to gen-
erate themes that describe the process of coping by the elderly with the feeling of abandonment.

FINDINGS

After thorough analysis of the participants’ individual and collective verbalization and sharings,
a new process emerged by which coping is achieved by a select group of abandoned elderly
individuals in nursing homes. The R.O.P.E. to Cope Theory of Abandonment depicts the process
by which elderly nursing home residents cope with abandonment by their loved ones. Parti-
cularly, this theory surfaced in the four distinct phases involved in the process: the resisting,
occupying, pondering, and embracing (see Figure 1).

Resisting Phase: The Struggle of the Elderly in the Nursing Home as They Face
Abandonment

In this study, the elderly may dismiss the reality that they were left in the nursing home. As
Filipinos, it is uncommon, if not rare, to find elderly people living in nursing homes. This begins
our process with the resisting phase wherein the newly admitted elderly are seen refusing to

FIGURE 1 The R.O.P.E. to Cope Theory of Abandonment. (Color figure available online.)
894 A. B. DE GUZMAN ET AL.

TABLE 1
Selection Characteristics

Respondent Age Sex Civil status Religion Length of stay Who brought you here? Who vists you?

A 63 Male Single Roman Catholic 3 years Voluntary Other visitors

B 76 Female Single Roman Catholic 4 years Social worker Other visitors
C 82 Male Married Roman Catholic 11 years Voluntary Other visitors
D 73 Female Separated Born Again 2 years Voluntary Other visitors
E 68 Female Separated Roman Catholic 5 years Social worker Other visitors
F 74 Female Single Born Again 1 year Social worker Other visitors
G 70 Male Single Roman Catholic 1 year Social worker Other visitors
H 73 Female Single Roman Catholic 4 years Social worker Other visitors
I 62 Male Single Roman Catholic 1 year Sibling Other visitors
J 65 Male Separated Roman Catholic 6 years Voluntary Other visitors
K 64 Male Separated Roman Catholic 1 year Social worker Other visitors
L 60 Female Widowed Roman Catholic 1 year Social worker Other visitors
M 71 Female Separated Roman Catholic 4 years Voluntary Other visitors
N 73 Female Single Roman Catholic 5 years Neighbor Other visitors
O 68 Female Single Roman Catholic 4 years Social worker Other visitors
P 73 Female Separated Born Again 2 years Voluntary Other visitors
Q 60 Male Single Roman Catholic 1 year Priest Other visitors
R 72 Female Single Roman Catholic 1 year Social worker Other visitors
S 70 Female Single Roman Catholic 5 years Social worker Other visitors
T 67 Female Widowed Roman Catholic 3 years Social worker Other visitors
U 61 Female Single Roman Catholic 1 year Voluntary Other visitors
V 73 Female Single Roman Catholic 6 years Social worker Other visitors
W 77 Female Single Roman Catholic 8 years Social worker Other visitors
X 76 Male Single Roman Catholic 5 years Social worker Other visitors

believe that they are to permanently live in the nursing home. Some of their significant
comments were as follows:

I really can’t accept that I am here, away from my family.

As I always say, my children will come back for me and get me out of here.
These comments reveal that the reality of the situation has not dawned upon the elderly; and
so, they refuse to accept any explanation offered to them. Some may even believe that they were
brought there by mistake. Immediately following their disbelief, the elderly focus on remember-
ing or recollecting their memories of how their lives were before being in the nursing home.
They long to be reunited with their families. They find strength in being together with their
family, and they admit to family being their only happiness. The following is how a few part-
icipants verbalized this:

All I want is my family! (gets teary eyed)

Every one of us here wishes for that: to see our loved ones.
I want to see him [son], and go home to the province; I have a lot of relatives there.
The participants also yearned to escape this new, unfamiliar, and restrictive environment and
return to their old lives that were defined by freedom. One even shared, ‘‘Because when you’re
 COPING WITH ABANDONMENT 895

outside, whatever you want to do, you can do. But here, there’s nothing; you can’t do what you want
to do.’’ As time goes by, participants’ thoughts that their family will visit or bring them home dim-
inish, and this fosters anger and ill feeling toward their loved ones. Moreover, the feeling of being
imprisoned in the nursing home adds to the notion of bitterness. Statements include the following:

Right now, I’m angry with them because they don’t visit me.
Why is it like that? (Voice cracks) When they were young, a little sickness and you’d bring them to
the hospital and watch over them. Supposedly in return, I’d be treated the same way, right? Now that
I’m older.
These statements show that this stage marks where the elderly begin resenting their loved
ones. They view their families as ingrates for not visiting them or not bringing them home. This
feeling at times overpowers them and leaves them betrayed and confused.

Occupying Phase: Setting the Feeling Aside and Relieving the Tension

To cope with the overwhelming feelings of resentment and anger, individuals resort to finding
ways to take their mind off such feelings. It has been deduced that the elderly have their own
way of diverting their attention to something else. This was verbalized as follows:

The only thing I can do to forget how lonely I am is to help out with the chores here in the nursing
home, like cleaning and washing the dishes.
I keep myself busy in the kitchen. I cook. I let it out through work; I don’t want to stop working.
Sometimes, I just sleep all my problems away.
As expressed by many of the respondents, they try to keep themselves occupied with activi-
ties. These activities include sleeping, working, and helping out with everyday chores. Others
prefer to do physical activities or exercise: ‘‘I was taught to exercise and to divert my attention.’’
Some elderly participate more in activities conducted in the nursing home, as shared by one:
‘‘Programs play a big part; because of those we become happy. We become happy with those
kinds of activities.’’ However, for others, they find relief in socializing with fellow residents.
This was indicated by a couple of the elderly:

When you’re already forgotten by your family, your attention and love will just be directed to
your friends.
When I have someone to talk to I forget all the bad feelings I have.
These statements show that this stage is characterized by diverting or redirecting one’s atten-
tion to other matters other than the feeling of abandonment, resentment, or anger. The elderly fill
their schedule with numerous tasks or activities so as to avoid having time alone to dwell on their
feelings.

Pondering Phase: Reflecting on One’s Self and Realizing the Truth

After exhausting all means to distract themselves, the participants found that their feelings
gradually returned: ‘‘However, at night when I’m alone, I tend to be lonely again.’’ ‘‘It’s only
896 A. B. DE GUZMAN ET AL.

a release of emotions. It’s only temporary because you make yourself busy.’’ Because of this, the
elderly then tend to give in to feelings of despair. One even mentioned: ‘‘I feel very lonely and I
ask myself what did I do so wrong to deserve this situation?’’ Hopelessness envelops them and,
eventually, they start to reflect and rationalize on the reason why they are there. They explore the
reasons behind their stay and start reasoning to themselves the possible explanation of their
existence in the nursing home:

I guess it’s normal to feel sullen, but when you do realize the good in it, you give them justification,
and then it disappears.
In my mind, I was asking myself, ‘‘What could possibly be the reason?’’ That’s what I asked myself.
But I thought that maybe, they just didn’t have enough money for travel fare.
Seeing how different reasons can sum up to their current living condition gave the parti-
cipants a sense of understanding. After seeing everything from different perspectives eventually
aided the particiapnts to reflect on themselves as the cause of being in the nursing home. It is
possible that one undergoes a period of self-loathing or self-blaming wherein he=she believes
they are the root of why they are in the nursing home and they start regretting. This stage also
emerges whentriggers of their feelings are present. It is in this stage where they truly feel the
impact of being abandoned and internalize all the pain. One shared, ‘‘Maybe I wasn’t or hadn’t
done enough for my family, that’s why they don’t visit me.’’ This feeling makes them vulnerable
and, in turn, causes them to belittle themselves.

Embracing: Accepting Reality and Moving Forward

As the elderly individual sees reality unfold before him, he enters the last phase of this theory
where he starts relying and lifting his whole life to what he believes is God’s master plan for
him. Since most of the interviewees were Roman Catholic, or believed in God as an eternal
being, he finds that there is hope in his situation when he puts himself in God’s hands. A
few described it this way:

God taught me to accept everything that has happened and I will always thank Him, for I know that
He has wonderful plans for me.
As the days passed, all my loneliness started to fade because I brought everything up to God and lay
everything to Him.
I just pray, ‘‘Lord, I lift everything up to You. I will now put it upon Your hands to save me from this
place. Whatever may happen to me and my children, it is all up to You.’’
The elderly find strength as they trust their fate in God. Along with strength, they find peace
in their situation as one shared, ‘‘I feel at peace now with the help of God.’’ With this new found
fortitude, they find themselves reconciling with the situation. They learn to accept their
circumstance and no longer have any ill feelings towards anyone. With this, an elderly person
mentioned, ‘‘I can now say that I am ready to die here in the nursing home because I am con-
tented with what I have.’’ These elderly people were able to realize the beauty of being content
with life and seeing the best in things, despite the seemingly unpleasant condition. Ergo, they
eventually feel grateful for the presence of the nursing home, as verbalized by one, ‘‘I’m thank-
ful that this institution exists.’’
 COPING WITH ABANDONMENT 897

DISCUSSION

Traditionally, Filipinos continue to live with their families well into old age. Much like other
Asian societies, Filipinos possess the value of filial piety, or duty to care for one’s parents
(Ng, Phillips, & Lee, 2002; Malaki, Soriano, & Valdez, 2009), manifested in being responsible
for material and mental well-being of aged parents (Ng & Bhugra, 2008). Thus, elderly people
who are left alone to fend for themselves foster the feeling of abandonment. This circumstance
may cause them to enter a nursing home for the remainder of their lives. This stressful experi-
ence of being neglected and adapting to a new environment requires the elderly to cope in order
to continue with their lives normally. Utilizing a grounded theory approach, this study success-
fully surfaced four distinct phases, embodied by the R.O.P.E. to Cope model, to describe the
process of how the elderly cope with their feeling of abandonment in the nursing home.
The resisting phase of coping shows that most of the elderly are not immediately able to grasp
the reality of their situation. At this stage, they are wishfully thinking that they could still get out
of the nursing home and be united with their families. The first part of this phase, the refusing
stage, is similar to the first step of Kubler-Ross’ (1969) five stages of grieving during which indi-
viduals initially use denial as a defense mechanism to reject the reality of the stressful situation
they are in. Elderly people undergoing this stage exert a great deal of effort to consciously or
unconsciously leave the light of their present situation either by verbalizing their refusal to
accept it or by persisting to believe that their families would come back to get them. Another
possible reason for their denial is to safeguard themselves from shame. They view their
placement in a nursing home as abandonment by their own children—that they are not wanted
or respected by them (Fitzgerald, Mullavey-O’Byrne, & Clemson, 2001). Next is the remember-
ing stage, wherein the elderly reminisce about their past experiences with their loved ones. This
stage is brought about by the elderly’s perceived psychosocial losses as a result of admission to
the nursing home: loss of self-identity, loss of freedom, and loss of meaning of identity, among
others (Forbes-Thompson & Gessert, 2006; Drageset, Kirkevold, & Espehaug, 2011). Hence,
they long for their lives as they were before admission to the nursing home. This recollection
of memories greatly affects their emotional response to the current situation and moves them
toward the next stage.
The final stage, resenting, results when the elderly people realize that their families have no
intention of visiting or bringing them home. They feel that they have been betrayed by their
loved ones because all the love and good things they have given to their families was not repaid.
The harboring of ill feelings toward their allegedly ungrateful families may be attributed to the
value debt of gratitude or reciprocity, wherein the family is expected to look after the aging par-
ent just as they were taken care of when they were young and vulnerable. Reciprocity is deeply
rooted in the Filipino values system, and it was described by Jocano in 1997 and Tuason in
2010.
With the need to resolve these internal conflicts rises the next phase in the coping process: the
occupying phase. It is best explained by Zuckerman and Gagne (2003), who stated that stressful
events trigger the individual to either approach or avoid the situation they are in through cogni-
tive and behavioral coping methods. As such, the elderly person tries to gain control over his life
in the redirecting stage. Here, he=she looks for ways to distract his=her attention from the nega-
tive feelings of anger, resentment, and abandonment. One example of such distraction is the
performance of physical activities and household chores. This is supported by Tanner (2007),
898 A. B. DE GUZMAN ET AL.

who claimed that elderly people facing difficulties engage in activities that keep them busy in
order to accommodate loss and change. Moreover, it was found that the elderly believed in
the value of keeping busy as it was helpful in sustaining their physical and psychosocial
well-being (Tanner, 2007).
Findings also show that the elderly divert their attention by cultivating positive relationships
(Bergland & Kirkevold, 2005) and emotional support from other nursing home residents (Lee,
2010). Further, a study done by Harper Ice (2002) suggests that the elderly spend close to equal
time in personal care and social=expressive activities. To compensate for this feeling of loss,
they begin to interact with fellow elders and get acquainted (Johnson & Barer, 1993). This
phenomenon may be explained by the social theory of reciprocity (Lawrence & Schiller-
Shigelone, 2002), which posits that individuals interact with one another to profit from the
association that they gain. In this study, it can be explained that the elderly utilize their experi-
ence of relating with other elderly in order for them to both benefit by having an outlet to release
their emotions. However, with the increased occurrence of chronic conditions during the aging
process, the capacity to exercise direct control over one’s life may diminish (Johnson & Barer,
1993). Besides experiencing a decline in functioning, the sense of loss of social support is likely
to be felt more.
The pondering phase emerges as a result of the elderly contemplating about how and why
they ended up in a nursing home. Although they were able to redirect their feelings of anger,
resentment, and abandonment into something that would keep them preoccupied, these negative
feelings would return at the end of the day. The reasoning stage explicates how the elderly try to
justify their current situation by exploring thoughts on the possible explanations behind their
stay in the nursing home. This is comparable to the defense mechanism known as rationalization,
which allows people to excuse themselves from painful realizations; hence, it may play an
essential role in maintaining their mental stability (Kay, Jimenez, & Jost, 2002). In relation to
this, some elderly may realize that their adult offspring may need time to develop their career
or care for their own children (Wu, Tan, & Yan, 2004). Others may find comfort in the thought
that staying in a nursing home relieves their family of the burden of taking care of them (Wilson,
1997; Nay, 1995; Jett, Coward, Schoenberg, Duncan, & Dwyer, 1996). As a product of rationa-
lizing, these elderly temporarily feel justified about living in the nursing home.
Eventually, the elderly people realize that their stay at the nursing home is not entirely their
family’s fault; it is also their own. This regretting stage is characterized by self-blame and
self-loathing. The feeling of remorse toward themselves may be attributed to the mentality that
they caused their own abandonment. They convince themselves that if they had been better
persons before, they would still be happy and with their families. This part of the process
may be similarly compared to Kubler-Ross’ (1969) stage of depression wherein an individual
disconnects from things that relate to love and affection. This is where grieving is full blown
and activities of daily living are, thus, altered. The health of the elderly may also be affected
negatively by such an immense feeling (Luanaigh & Lawlor, 2008). Further, hopelessness devel-
ops as a result of loss of control, and it may be exacerbated during institutionalization (Mercer &
Kane, 1979, as cited by Berdes in 1987; Chiang et al., 2009).
At one point of the coping process, the embracing phase, it has been found that the elderly use
faith to find peace within themselves and to ultimately accept their fate. As discussed in Aylott’s
(1998) review of hopelessness, a person with an external locus of control believes that events hap-
pen via fate, luck, God, or other factors that are beyond their personal control. The relying stage
 COPING WITH ABANDONMENT 899

describes the period when the elderly surrender to a higher being who they believe has greater
plans for them. This stage can be likened to a study conducted by Tix and Fraser (1998) where
they termed it as religious coping: the use of cognitive and behavioral techniques, in the face of
stressful life events, that arise out of one’s religion or spirituality (as cited by Karekla &
Constantinou, 2010). In line with this, it was suggested that religiousness enhances psychological
well-being (Scandrett & Mitchell, 2009). Moreover, individuals with strong religious ties are able
to handle stressors with greater resilience than others (Oman & Reed, 1998).
If the elderly are successful in undergoing the process of coping, the end result is acceptance
of their new life in the nursing home. The elderly reconcile with themselves and embrace this
new found realization. This runs parallel to Kubler-Ross’ (1969) five stages of grieving; at
the end of the process, the individual comes to terms with reality and opens the opportunity
to move on with meaning and hope. For some, however, nursing homes are not able to provide
individual needs to develop meaning for their everyday lives (Groger, 1995); thus, they end up
resigning to the situation with apathy.

CONCLUSION

This study has vividly described the process by which a select group of Filipino elderly in nursing
homes cope with abandonment. Gathered information showed that these respondents undergo
four major phases to successfully achieve coping: resisting, occupying, pondering and embracing.
The first phase, resisting, describes the elderly denying their admission to the unfamiliar nurs-
ing home and longing to return to their past lives and loved ones. The second phase, occupying,
explains how the elderly divert their attention to avoid dwelling on their feelings of abandon-
ment. The third phase, pondering, is when the elderly explore the reasons behind their existence
in the nursing home and truly feel the impact of being abandoned. The fourth and final phase,
embracing, shows the elderly lifting their lives up to God’s divine plan and accepting their fate in
the nursing home.
Findings of this study can be expected to increase health care providers’ awareness and
understanding of the process of coping among abandoned elderly in nursing homes. The
R.O.P.E. to Cope Theory of Abandonment may serve as a valuable guide in identifying and
addressing specific needs of these elderly. This could also be deemed helpful in devising and
employing appropriate interventions that ensure normal and successful transition as the elderly
move from one phase to another. In so doing, nurses are able to provide holistic and compassion-
ate care; and ultimately they can aid the elderly to achieve an improved quality of life and a hap-
pier perspective on it.

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