CHAPTER I

INTRODUCTION

The Problem and Its Background

The fast rising of elderly population around the globe

correspondingly means an expansion of cohesive issues that should

be answered. For the same instance that elderly person gives a

great impact to the community, there needs should be given

appropriate rendition of care and extensive understanding. The

issue that the elderly are facing is amplified and interrelated.

Our elderly should not be seen as a burden to our society. In

fact, they still can be productive citizens in their own little

ways.

As the world becomes smaller through the use of high

technology that makes it easy for travel and communication, the

importance of a more global perspective and the differences in

aging across the globe is hardly needed. Most of the countries

around the globe are experiencing a demographic transition

towards aging population. As for our country, the Philippines’

population as of the year 2012 in terms of people ages15-64 years

is 61.1% (for the male 31,103,967 and for the female 31,097,203)

and for the elderly ages 65 years and above is on 4.3% (for male

1,876,805 and for female is 2,471,644)(Philippines Demographic

Profile 2012 CIA World Factbook, July 19, 2012). In such case

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that is also prevalent to the Municipality of Catarman, Northern

Samar were in the aging population is approximately more than 600

elderly in the whole population among the 23 town proper

barangay.

Older adults collectively experience a wide array of

perceptions coming from younger society. Perceptions about older

adults vary from one to another. Family caregivers of adults also

often faced with problems as to the living options. Decision

making for older adults may be viewed by some as declining, thus

ignoring their autonomy to decide for themselves. This only shows

our responsibility and the obligation not to neglect the idea of

improving the perception of the family caregivers with regards to

the elderly because it will affect the kind of care rendered to

them.

Thus, the researchers, as future nurses equipped with the

knowledge about the care of the elderly, are inquisitive on how

the family caregivers a present perceived the elderly.

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Statement of the Problem

General Problem

This study will seek to find out the Perceptions of

Family caregivers about the biologic and psychosocial aspects of

the Elderly in Municipality of Catarman, Northern Samar.

Specific Problems

Specifically, it will seek to answer the following

questions:

1. What is the demographic profile of the family caregiver

of the elderly in terms of:

A. Age

B. Sex

C. Educational attainment

D. Relationship with elderly

E. Length of Service as caregiver

2. What are the perceptions of family caregivers in terms of

the biologic and psychosocial aspects of the elderly?

3. What is the significant relationship of the demographic

profile of the family caregivers to their perception

about the elderly in terms of their biologic and

psychosocial aspects?

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Objectives of the Study

This study aims at finding out the perception of Family

Caregivers about the elderly in the Municipality of Catarman,

Northern Samar.

Specifically, this study aims to:

1. Determine the demographic profile of the family

caregivers of the elderly in terms of age, sex,

educational attainment, relationship with elderly and

length of service as caregiver.

2. Determine the perceptions of the family caregivers about

the elderly in terms of their biologic and psychosocial

aspects.

3. Determine the relationship of the demographic profile of

the family caregivers to their perception of about the

elderly.

Significance of the Study

The findings of this study will make the family caregivers

aware about the new trends in rendering appropriate care to the

elderly persons.

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Basically, the following group of individuals and

institution will be benefited by this study;

Elderly. This study will help the elderly to know about the

perceptions of family caregivers towards them.

Family Caregivers. This study will help the family to

understand the importance of caring elderly client.

Nursing Students. The result of this study will make them

aware of the ideas to the perception of the family caregivers

towards the elderly.

Colleges of Nursing. The result of the study will help the

colleges to recognize as to what proper learning or proper

teaching to expound the perception of future nurses about

elderly.

Researchers. The result of this study will help the

researcher identify and evaluate which among of the factors

mentioned affect most the perception of family caregivers to the

elderly.

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Scope and Limitation

This study will focus on the Perception of selected family

caregivers about the elderly. It will cover the twenty-three (23)

town proper barangay out of the 46 mainland Barangays of the

municipality of Catarman Northern Samar.

Considering the financial and time constraints in conducting

of this study, the respondent will be choosen from the above the

(23) urban barangays, located in the town proper, namely: Acacia,

Airport Village, Bangkerohan, Baybay, Cabayhan, Cag-abaca,

Calachuchi, Cal-igang, Casoy, Cawayan, Dalakit, Ipil-ipil, Jose

Abad Santos, Jose P. Rizal, Lapu-lapu, Mabini, Mabolo, Molave,

Narra, Sampaguita, Santol, Talisay and Yakal. The researchers

also consider the easy accessibility of the respondents in

conducting the study. Hence, as a study of perceptions the

reliability of the finding depends on the veracity of the

subjects response and the level of willingness of the respondents

to participate in the study.

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Hypothesis

There is no significant relationship between the demographic

profiles of the family caregivers to their perception about

the elderly.

Theoretical Framework of the Study

This study makes use of a core theory and several theories

related to it which will serve as strong bases to make this study

realistic.

Toughy and Jett Theories of aging served as bases for this

study. It was suggested that some cognitive functions in old age

decline people regardless of age can continue to learn. The

cognitive skills that remain stable are attention span, language

skills, communication skills, comprehension and discourse and

visual perception. Some of the skills that decline with age are

verbal fluency logical analysis, selective attention object

naming and complex vision spatial skills. (Toughy and Jett 2010)

According to Toughy and Jett older adults who have higher

cognitive function are the ones that have the highest social

interaction. Older people continue to learn from their

experiences and understand new situations (Toughy and Jett

2010).It also tackles the four types of aging which includes

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chronological age, biological age, psychological age, and social

age these ages may not be the same on a person. Chronological age

is the number of years a person has lived. Biological age is the

predicted by the person’s physical condition and how well vital

organ systems are functioning. Psychological age is expressed

through a person’s ability and control of memory, learning

capacity, skills, emotions, and judgment, Social Age is measured

by age graded behaviors that conform to an expected status and

role within a particular culture or society.

It was anchored on Phillips’ Family Caregiving Dynamics

model. The concept of the model include both interactional

context factors, such as the caregiver’s role expectations and

expectations of the care recipient, and situational context

factors, such as the care recipient’s abilities. It also includes

the perceptions that the caregiver and care recipient have about

the situation such as the caregiver burden. This model provides

framework for understanding poor caregiving, with attention to

many factors, including the prior relationship history of the

caregiver and the care recipient. (Phillips, Brewer, & Torres de

Ardon, 2001)

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Conceptual Framework of the Study

We know for a fact that as the age of a person increases,

the biologic and psychosocial aspects of a person has to be

considered significant. These changes could greatly affect the

public’s perception most especially to the perceptions of the

family caregivers. This study will conceptualize on the

assumption that factors such as age, sex, educational attainment,

length of service and relationship with elderly have a

relationship to the perceptions of the family caregivers about

the elderly.

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Paradigm of the Study

Independent Variables Dependent Variables

Prp

Figure1. The diagram shows the relationship between the

independent and the dependent variables.

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Profile of a respondent family caregiver in terms of:

Age Sex Educational

attainment Relationship with

elderly Length of service

Family Caregivers Perception in terms

of:a. biologic

aspectb. psychosocial

aspect

Definition of Terms

Elderly. It is conceptually defined rather old especially being

past middle age.

In this study, it refers to the characteristics of later

life of a person.

Family Caregiver. It is conceptually defined as a person who

provides direct care (as for children, elderly people, or the

chronically ill).

In this study, it refers to the Family caregivers of the

elderly.

Perception. It is conceptually defined as Awareness of the

elements of the environment through physical sensation or

physical sensation interpreted in the light of experience.

Furthermore, it is any insight or intuitive judgment that

implies discernment with truth or fact. This includes the

beliefs, views, of a certain person about the elderly as measured

by the Self-Assessment on beliefs about the Elderly

Questionnaire.

In this study, it refers to the insight of the Family

caregivers towards the elderly.

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Chapter II

Review of Literature

Related literature

The aging process is of course a biological reality which

has its own dynamic, largely beyond human control. However, it is

also subject to the constructions by which each society makes

sense of old age. In the developed world, chronological time

plays a paramount role. The age of 60 or 65, roughly equivalent

to retirement ages in most developed countries is said to be the

beginning of old age. In many parts of the developing world,

chronological time has little or no importance in the meaning of

old age. Other socially constructed meanings of age are more

significant such as the roles assigned to older people; in some

cases it is the loss of roles accompanying physical decline which

is significant in defining old age. Thus, in contrast to the

chronological milestones which mark life stages in the developed

world, old age in many developing countries is seen to begin at

the point when active contribution is no longer possible."

(Gorman, 2002)

Unlike child care, which typically involves finding services

primarily for healthy children who live with the employee, elder

care requires a set of services to respond to a wide range of

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often unpredictable medical, emotional, physical and financial

possibilities. These services are frequently required to be

delivered some distance from the employee. Elder care takes many

forms, including providing meals, transportation to medical

appointments, food shopping, financial assistance, assisting with

housework or providing emotional support. When elder-care needs

occur, they tend to be unpredictable and involve many unknowns.

These needs often cause anxiety about things such as the ability

to find and pay for immediate care or ways to take preventative

measures like withholding car keys away from an elderly parent.

Employees with elder-care responsibility are often called upon to

assist in making costly financial decisions around issues of

long-term care. In many cases, they have very little information

and little confidence in their ability to get comprehensive

information on public and private benefits, service and financial

options, and risks of needing extensive care overtime. Adult

children usually want to respect the autonomy and decision-making

capability of their older adult relatives. However, most people

are not proactive when it comes to elder care and critically

important discussions about “what to do if” rarely take place in

advance. (Rose and Burut, 2006; pg.62)

The American Journal of Nursing (AJN) recognizes that

nurses today will care more adults over 65 than any other patient

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population. Caring for older adults requires specific expertise,

knowledge and skills that the majority of nurses did not learn in

school, and or which less than one percent have has specialized

training or certification.

During the last decade and primarily because of the aging

population and the dual-focus workforce, the time one adult

spends caring for another adult has emerged as a workplace issue.

Finding and coordinating elder-care services is no easy task,

especially for an employed caregiver. The study overwork in

America: when the way we work becomes too much (families and work

institute 2004) found that employees with elder-care

responsibilities tend to be more overworked than employers

without these responsibilities.

Caring for elderly patients can be a double-edged sword. On

the one hand, it is a demonstration of concern for the person

involved, but on the other, the paramount feeling when a patient

cannot no longer do the things for themselves that they used to

do is uselessness, which leads to sadness, laziness and self-

loathing. Patients may eat more and start to gain weight, and

actually decline in health. If that is the case, then there is no

better time for these individuals to get off that couch and start

moving.

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This only shows that elderly persons are much dependent with

the tender loving care that their health care providers are

rendering thru them. But since that few programs were implemented

locally, concerning the necessities that our government should

have. This study also tackles about the insights and perspective

of each caregiver family member to an elderly person that belongs

to their family.

Related Studies

The study of Christina Englert, MA, Center for Language &

Cognition, University of Groningen (Sept. 2008 )“Elderly people

talking: The production of Elderly Identity in Interaction”

examined how the identities of elderly people are socially

constructed and marked in interaction by means of linguistic

practices and how this can be influenced by the conversational

setting. The aim of this research is to give a general idea of

the range of communicative activities of elderly by means of a

communication profile. The aim is to describe, from an

interactional perspective, relevant linguistic practices and

communicative activities that are characteristic and constitutive

for a certain number of typical communicative situations and

genres where elderly participate.

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In every culture life circumstances change for an aging

individual and there are typical experiences in the areas of

social situations and relationships (e.g. retirement, health

condition, widowhood, loss of driver’s license, moving to a

retirement home). The processing of all these changes and

experiences are not only carried out cognitively but also

communicatively: they shape the linguistic, communicative

behaviour of elderly people. The communicative milieu (e.g.,

neighbourhood, family, shopping places, healthcare settings) of

elderly people can be characterized by regular, more or less

standardized, stable social relationships with a shared history,

specific communicative repertoires and more or less normative

rules that govern the interaction.

Previous Conversation Analytic studies of the discourse of

elderly tend to focus on interactions taking place in care-giving

institutions or home-help contexts between the elderly and their

care-givers during care activities (cf. Backhaus, 2010;

Engbersen, 2009; Heinemann, 2006; Lindström, 2005)

According to the study conducted by Caroline G. Lee, the

Role of an Aged Care Nurse Practitioner (ACNP) is well recognised

internationally however, in Australia the implementation of this

advanced role is still in its infancy with few gerontological

nursing experts registered as nurse practitioners (NP). This

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single Victorian Facility 2002 study was the first to describe

the clinical & social benefits or otherwise of ACNP interventions

in an Australian context.

This study aimed to establish clinical or other outcomes

that a Gerontological Nurse Practitioner (ACNP’s) could achieve

for older persons in an Australian residential aged, care

facility.

In summary, this study identified interventions an ACNP

could undertake & therefore the role they could play in an

Australian residential aged care facility, given the national

legislation governing all aspects of an aged care facility. This

study demonstrated that the role was feasible and achieved

positive resident outcomes despite the factors that impeded its

introduction.

The study about Nurses’ Perceptions and Support of Elderly

Loneliness in Nursing Homes (Edith Mutafungwa Degree Programme in

Nursing Thesis, February 2009.) The purpose of the study is to

find out how nurses perceive elderly loneliness. A qualitative

research method was used in the study. The thesis topic

originated from the project “Experiences of Loneliness”, which

was innovated by Espoo City. The data was collected from

Taavinkoti (nursing home) based in Espoo from November to

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December 2008. Consent and information letters were sent to

nurses prior to their participation in the study.

In addition, nurses described that the absence of family

members in an elder’s life plays a significant role in an

individual’s loneliness. The study showed the supporting methods

offered by nurses were nursing assistance, psychological support,

physical support and social participation.

According to the study of Maria Linda S. Agus, MAN about the

perception of public health Nurses & family caregivers of the

elderly in Catarman Northern Samar, the findings of the study

with regards to the profile data specifically age as one of the

variables is that most of the respondents both from the CHN &

family members belonged to the aged bracket of 32-37 & which 35-

39 years old respectively, is under the early adult stage.

Chapter III

Methodology

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Locale of the Study

Catarman is a first class municipality in the province of

Northern Samar. It is the capital and largest town by land area

and population in Northern Samar. According to the 2010 census,

it has a population of 84,833 in 12, 437 household making it the

most populous municipality in Eastern Visayas. It has an area of

464.23km2 (179.32 sq. mi). It is also the commercial,

educational, financial, political, and socio-cultural and

government center of the province. It lies on the northern part

of Samar Island and southeast of the Philippine capital, Manila.

It is bounded to the east by Mondragon, to the west by Bobon, to

the south by Lope de Vega, and to the north by the San Bernardino

Strait. The municipality is skirt-shaped. On the Pacific coast

are flat lowlands with the interior characterized by outlying low

hills. Mt. Puyao in Barangay Liberty is the highest peak in the

area.

Catarman representatively standing for the business region

of Northern Samar is in the process of renewing its image as a

poor and underdeveloped area in the 1980s. Due to its direct

topographic contact to Luzon the area serves now as a trading

center in Northern Samar with increasing volume of trade and

commerce annually.

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At present, Catarman town proper have 23 urban mainland

barangays, these are Acacia, Airport Village, Bangkerohan,

Baybay, Cabayhan, Cag-abaca, Calachuchi, Cal-igang, Casoy,

Cawayan, Dalakit, Ipil-ipil, Jose Abad Santos, Jose P. Rizal,

Lapu-lapu, Mabini, Mabolo, Molave, Narra, Sampaguita, Santol,

Talisay, Yakal. The town also currently has five public health

nurses.

Research design

This study will utilize the descriptive correlational survey

method of investigation to determine the perception of the public

health nurses and family caregivers about the elderly.

Correlational design is used in this study to determine the

relationship of the demographic profile of the respondents which

are the public health nurses and family caregivers to their

perception about the elderly.

Research Respondents

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The identified respondents of this study are categorize into

two (2): the first group composes the selected family caregivers

of the elderly and the second group are the five Public Health

Nurses of the Municipality of Catarman, Northern Samar.

Research Variables and their Measures

The variables that will be use in this study are quantified

in the following manner:

Age. This refers to the number of years that the family

caregivers has lived from birth up to present.

Gender. It refers to the characteristics which determine whether

both of the family caregivers are male or female.

Educational attainment. It refers to the highest level of

education attained by family caregivers.

Length of service. It refers to the family caregivers’ number of

years in service with the elderly.

Relationship with the elderly. It refers to the blood relation of

the selected family caregiver with the elderly.

Research Instrument

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The researcher will make use of a standardized tool adopted

and modified from a study entitled “Community Health Nurses and

Family Members’ Perceptions of the Elderly in the Province of

Northern Samar, Proposed Health Teaching Plan” (Agus,1996).

Modification made was inclusion of relationship of the family

caregiver to the elderly as one of the variables.

Part I of the questionnaire will determine the demographic

profiles of the family caregivers.

Part II of this instrument will measure the family

caregivers’ perception about the biological and psychosocial

aspect of the elderly. It consists of nine biological perceptions

and twelve psychosocial perceptions about the elderly.

It will be completed by placing a check mark on the

appropriate column- SA if they Strongly Agree; A if they Agree; U

if they are Undecided; D if they Disagree and SD if they Strongly

Disagree.

Sampling Technique

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This study will utilize the Slovin’s formula to determine

the sample size. In order for the barangays to have an equal

representation, proportionate sampling will be done after getting

the sample size in every barangay. The researchers will pick from

a bowl with name of the families with elderly per barangay and

the names that will be picked will be taken as the respondents.

This technique will be used based on the belief that researchers’

knowledge about the population can be used to hand-pick sample

members to which in this study are the family caregivers.

Date Gathering Procedure

Prior to the study, letters of request to conduct the study

will be sent out to the Municipal Health Officer of the Rural

Health Unit of the selected Municipality which is Catarman,

Northern Samar. The researchers will personally distribute the

questionnaires to the family caregivers and retrieve them

immediately on the very day they will be administered. Collection

of data from the family caregivers will be done through

structured interview schedule.

Scoring and Interpretation of Data

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The following scoring and interpretation will be employed in

this study.

A. Demographic Profile of family caregivers will utilize

frequency count and percentages:

a) Age

The age of family caregivers will be categorized

based from the psychosocial theory of Erik Erikson’s

which are as follows:

Young Adulthood (18-25 years old)

Middle Adulthood (25-60 years old)

b) Gender

The gender of family caregivers will be categorized

as male or female.

c) Educational Attainment

The educational attainment of the family caregivers

will be categorized as:

Elementary

High School

College level

College Graduate

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Others, please specify

e.) Length of Service

The length of service of family caregivers will be

categorized as:

31-35 years

26-30 years

21-25 years

16-20 years

11-15 years

6-10 years

1-5 years

f.) Relationship with Elderly

The relationship with the elderly of the family

caregivers will be categorized as:

Daughter/Son

Grandchild

Niece/Nephew

Son/daughter in Law

Husband/wife

Relatives

B. Self-Assessment on Perceptions of the Elderly

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The researchers will base the scoring and

interpretation of the study from the adopted and modified

questionnaire. It will be interpreted through item per item

analysis.

The responses of family caregivers will be scored as

follows:

Range INTERPRETATION

Quantitative

Interpretation

Qualitative Interpretation

4.20 – 5.00 Very Positive The respondents perceive the

elderly as holistically functional

individual of the society.

3.40 – 4.19 Positive The respondents perceives elderly

as functional individual yet has

their own limitation

2.60 – 3.39 Undecided The respondents cannot decide on

the abilities of the elderly as

functional human being

1.80 – 2.59 Negative The respondents perceives the

elderly as individual with

decreased functional ability

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1.00 – 1.79 Very Negative The respondents perceives the

elderly who has absence of

functional ability

Interpretation of the result will be done by assigning

descriptive interpretation for every response. For the negatively

stated items which include item numbers: 1,2,3,4,5,6,7,8,7,11,12

interpretation will be “very positive” to a strongly agree

response; “positive to an agree response; “undecided” to an

undecided response; “negative” to a disagree response and “very

negative” to a strongly disagree response. For the positively

stated items which include 9,10,13,14,15,16,17 interpretation

will be “very positive” to a strongly disagree response;

“positive” to disagree response; “undecided” to an undecided

response; “negative” to an agree response and “very negative” to

a strongly agree response.

Statistical Treatment of Data

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The study was analyzed statistically based on the presented

data gathered during our survey on every family caregiver in the

province of Northern Samar.

These are the statistical tool used in or study.

1. Frequency and personal distribution

Percent (%) = f x100N

Where:

P = Percent (%)

f = frequency/response

N = total # of case

100constant factor

2. Mean

a. The mean was used in analysing the status of

implementation of the data gathered in the survey to

measure the overall reaction of several variables

The formula is:

x=∑fxN

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Where:

X = mean

∑fx = summation of frequency

N = total number of respondents

3. The Multiple Regression Analysis to be use to determine the

relationship of demographic profile of the family caregivers

to their perception about the elderly.

The Multiple Regression Analysis

The Multiple Regression Analysis is used in

predictions. The dependent variable can be predicted given

several independent variables. For instance, we can make

better predictions of the performance of newly hired

teachers if we consider not only their education but also

their years of experience, personality, and other variables

that may influence performance.

Many mathematical formulas can serve to express

relationship among more than two variables, but the most

commonly used in statistics are linear equations.

y = b0 + b1 x1 + b2x2= ... + bnxn

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where:

y = the dependent variable to be predicted

x1x2...xn = the known independent variables that may

influence y

b0b1b2..bn = numerical constants which must be determined from

observed data

For instance, when there are two independent variables

x1 and x2 and we want to fit the equation, the equation

model:

y = b0 + b1x1 + b2x2

we must solve the three normal equations:

Σy = nb0 + Σx1b1 + Σx2b2

Σx1y = Σx1b0 + Σx 21b1 + Σx1x2b2

Σx2 = Σx2b0 + Σx1x2b1 + Σ x 22 b2

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