Volume 13, Issue 2 (7-2018)                   Salmand: Iranian Journal of Ageing 2018, 13(2): 262-279 | Back to browse issues page


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Nouri A, Farsi S. Expectations of Institutionalized Elderly From Their Children. Salmand: Iranian Journal of Ageing 2018; 13 (2) :262-279
URL: http://salmandj.uswr.ac.ir/article-1-1396-en.html
1- Department of Education, Faculty of Literature and Humanities, Malayer University, Malayer, Iran. , a.nouri@malayeru.ac.ir
2- Department of Education, Faculty of Literature and Humanities, Malayer University, Malayer, Iran.
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Extended Abstract
1. Objectives

Although the government and other private and supportive institutions can play a vital role in caring for the elderly, it is not comparable to that of the family [12]. However, for different reasons, some elderly individuals may be deprived of life with their family members and may need to reside in centers with different titles such as the “senior home” or “seniors” accommodation. Previous studies indicated an unfavorable situation of the elderly living in nursing care centers as compared to those residing at home [13-16].
In addition, this study identified the types of concerns and the expectations of the elderly residents of the nursing home from their children. Identifying the needs and concerns of the elderly could aid in organizing the living conditions in a nursing home environment such that it increases their satisfaction. Also, the elderly’s family can be encouraged to make efforts to meet their relative’s expectations.
2. Methods and Materials
This study is a qualitative approach that has been implemented using the “culture mapping” method. The participants included 30 individuals, selected among those residing in one of the nursing homes of Malayer. The selection criteria were as follows: having at least one child, the residence of >6 months at the nursing home, ability, and willingness to participate in the interview. The semi-structured interview was conducted in the nursing home‌ to collect data over a 10-month period and completed in 18 sessions of 3 h each. The duration of each interview was 20-50 min and half of the participants were interviewed more than one time. The data were analyzed by thematic analysis method. Each interview was reviewed in order to obtain a general view of the meaning and purpose of the interviewee. Then, the content of each interview was named in initials code and meaningful units. Next, the codes with common features were named in a single set as the concept, and finally, the concepts with common features were categorized in a broad category termed as themes. 
The precise recording of data collection, analysis steps, and the process of extracting themes and concepts revealed the validity of the reported findings. The representation of extraction codes and inferred concepts, as well as their documentation based on direct quotations from the participants in the findings section, suggested that all views, values, ​​ideas, and their reflection are presented without bias. In addition, the findings were transferable. To confirm the findings, two associates outside the research revised the codes and concepts extracted from the data, and the findings were reported based on their suggestions.
Code of ethics to conduct this research was based on a license obtained from the Research Deputy of the University of Malayer for the project approved with issue No. 218-1-5/84.
3. Results
The results of this study led to identifying the four basic expectations of the elderly parents from their children and are summarized in Table 1. The first category of seniors’ expectations of children was physical care and supplying their health needs; for example, supplying proper nutrition suitable for the physical status of the elderly, helping to administer medications and provide first aid, acceptance and tolerance of their physical health problems, and helping them to address daily personal health issues. With an emphasis on physical care, the elderly participating in research stressed that the living conditions at the nursing home served as one of the main factors in encouraging them to express such expectations.
The second parameter extracted from the analysis of the data was social support and respect for the dignity of the elderly. This category included concepts such as the admission of the elderly as a member of the family, an early and continuous visit to them, reverence and respect for their social status, empathy and sympathy with them, and sharing of the administration of family affairs with them. While expressing such expectations, the elderly participants noted the importance of the role of social support in their physical and mental health.
The third theme was expecting emotional support from children and maintaining the privacy of the elderly by the children. Maintaining and strengthening the positive mood and self-confidence of the elderly, maintaining and enhancing their self-esteem, maintaining and strengthening their independence and autonomy, attracting their trust and confidence, and creating a warm and intimate atmosphere were among the major concepts describing these expectations. The elderly emphasized that emotional and empathic communication of family members increases their sense of vitality. 
Financial support and basic needs of the elderly comprised the fourth theme extracted from the data of the present study. In this theme, the measures such as providing basic living expenses, maintenance of their assets and financial capital, their contribution to family business activities, respecting their opinion and decision regarding the division of their heritage, and allowing them to decide on their income play an essential role in meeting this expectation. The elderly participating in research pointed their vital role in the economic progress of the family and society and stressed that they should be considered as valuable social capital for the community.
4. Conclusion
The results of this study explicitly and implicitly demonstrated that institutions providing health and psychological services attempt to develop and implement educational programs in order to introduce the elderly and familiarize all citizens to the distinctive growth characteristics of the aging period and the concerns and challenges of the elderly. Attempting to implement the “intergenerational learning” programs [2, 3, 12] is another measure that can be effective in reducing the gap between the young and older generations. Such programs would improve the intergenerational coherence and reduce anger, fear, and distrust among them while encouraging the young and elderly citizens to avoid any prejudices towards each other [2]
Although the results of this study can also be inspirational and informative for caregivers of the elderly and the scientific community interested in exploring the field of aging, the population was limited to the elderly residing at one of the elderly care centers of Malayer. Thus, future studies need to identify the expectations of the elderly living at home as compared to those living in the nursing homes. In this study, the mutual expectations of the elderly’s children were not identified. Thus, these also need to be identified for an improved understanding and relationship between the elderly and children. Furthermore, concerns of the caregivers of the elderly should also be addressed in order to identify their needs and priorities appropriately.
Ethical Considerations
Compliance with ethical guidelines

In this research, ethical considerations of research are based on the moral standards of the American Psychological Association. The main purpose of the research was explained to all participants and they participated with informed consent in the research. No psychological or social harm was reported to the participants, and all information was kept confidential. The ethics code of the present study was based on the permission of the Research Deputy of the University of Malayer for the research project approved by No. 84/5-1-218, which provided all participants in the study and assured them that their information was only used to achieve the objectives of this research.
Funding
This article was extracted from a research project with the code of 84/5-1-218, financially supported by Malayer University.
Conflict of interest
The authors declared no conflict of interest.
Acknowledgements
All the officials and staff members of the elderly community in Malayer and all the elderly and the participants in this study are appreciated.

 
References
  1. United Nations. World population prospects, 2008 revision. New York: United Nations: 2010.
  2. Han M. Health care of the elderly in Myanmar. Regional Health Forum. 2012; 16(1):23-28.
  3. Findsen B, Formosa M. Lifelong learning in later life: A handbook on older adult learning. Rotterdam: Sense Publishers; 2011. [DOI:10.1007/978-94-6091-651-9]
  4. Mirzaei M, Shams Ghahfarokhi M. [Demography of elder population in Iran over the period 1956 to 2006 (Persian)]. Iranian Journal of Ageing. 2007; 2(3):326-31.
  5. Statistical Centre of Iran. [Outset of the national population and housing census 2011 (Persian)]. Tehran: Statistical Centre of Iran; 2012. 
  6. Greaves CJ, Farbus L. Effects of creative and social activity on the health and well-being of socially isolated older people: outcomes from a multi-method observational study. Journal of the Royal Society for the Promotion of Health. 2006; 126(3):134–42. [DOI:10.1177/1466424006064303]
  7. Ollonqvist K, Palkeinen H, Aaltonen T, Pohjolainen T, Puukka P, Hinkka K, et al. Alleviating loneliness among frail older people–findings from a randomised controlled trial. International Journal of Mental Health Promotion. 2008; 10(2):26-34. [DOI:10.1080/14623730.2008.9721760]
  8. Crist, JD. Crist JD. The meaning for elders of receiving family care. Journal of Advanced Nursing. 2005; 49(5):485-93. [DOI:10.1111/j.1365-2648.2004.03321.x]
  9. Murphy E. Social origins of depression in old age. The British Journal of Psychiatry. 1982; 141(2):135-42. [DOI:10.1192/bjp.141.2.135]
  10. Yazdanpur F, Sam Aram E. [Effective factors on life quality of elderly in Khomein (Persian)]. Social Development & Welfare Planing. 2011; 2(6):45-63.
  11. Gholizadeh A, Shirani A. [The relation between personal, family, social and economic factors with the rate of life satisfaction of aged people of Isfahan (Persian)]. Journal of Applied Sociology. 2010; 21(1):69-89.
  12. Knodel J. Intergenerational Family Care for and by Older People in Thailand. Paper presented at the Conference on Shifting Boundaries of Care Provision in Asia: Policy and Practice Changes, Asia Research Institute; 2011 March 14-15; Singapore, India.
  13. Drageset J, Natvig GK, Eide GE, Clipp EC, Bondevik M, Nortvedt MW, et al. Differences in health‐related quality of life between older nursing home residents without cognitive impairment and the general population of Norway. Journal of Clinical Nursing. 2008; 17(9):1227-36. [DOI:10.1111/j.1365-2702.2007.02132.x]
  14. Salehi L, Salaki S, Alizadeh L. [Health-related quality of life among elderly member of elderly centers in Tehran (Persian)]. Iranian Journal of Epidemiology. 2012; 8(1):14-20.
  15. Mokhtari F, Ghasemi N. [Comparison of Elderlys Quality of life and mental health living in nursing homes and members of retiered club of Shiraz city (Persian)]. Iranian Journal of Ageing. 2011; 5(4):53-63.
  16. Abdollahi F, Mohammadpour RA. [Health related quality of life among the elderly living in nursing home and homes (Persian)]. Journal of Mazandaran University of Medical Sciences. 2013; 23(104):20-5. 
  17. Panah Ali A. [A comparison between the level of happiness among the elderly living at home and that of senior home residents (Persian)]. Iranian Journal of Ageing. 2011; 6(3):49-55.
  18. Evangelista RA, Bueno A de A, Castro PA de, Nascimento JN, Araújo NT de, Aires GP. Perceptions and experiences of elderly residents in asylum. Revista da Escola de Enfermagem da USP. 2014; 48(spe2):81–6. [DOI:10.1590/S0080-623420140000800013]
  19. Boyle JS. Styles of ethnography. In J. M. Morse editor. Critical Issues in Qualitative Research Methods. Thousand Oaks, CA: Sage; 1994.
  20. Van Maanen J. Tales of the field: On writing ethnography. Chicago: University of Chicago Press: 2011. [DOI:10.7208/chicago/9780226849638.001.0001]
  21. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology. 2006; 3(2):77-101. [DOI:10.1191/1478088706qp063oa]
  22. Mertens DM. Research and evaluation in education and psychology. Thousand Oaks, London: Sage Publications: 2005.
  23. Hemmati Alamdarlou G, Dehshiri G, Shojaie S, Hakimi Rad E. [Health and loneliness status of the elderly living in nursing homes versus those living with their families (Persian)]. Iranian Journal of Ageing. 2008; 3(2):557-64.
  24. Momeni K, Karimi H. [The comparison of general health of the residents/non residents in the elder house (Persian)]. Iranian Journal of Ageing. 2010; 5(3):23-29.
  25. Alipour F, Sajadi H, Forouzan A, Nabavi H, Khedmati E. [The role of social support in the anxiety and depression of elderly (Persian)]. Iranian Journal of Ageing. 2009; 4(1):147-165.
  26. Iden KR, Ruths S, Hjørleifsson S. Residents’ perceptions of their own sadness-a qualitative study in Norwegian nursing homes. BMC geriatrics. 2015; 15(1):21-28. [DOI:10.1186/s12877-015-0019-y]
  27. Hesamzadeh A, Maddah SB, Mohammadi F, Fallahi Khoshknab M, Rahgozar M. [Comparison of elderlys” quality of life” living at homes and in private or public nursing homes (Persian)]. Iranian Journal of Ageing. 2010; 4(4):66-74.
  28. Ghasemi H, Harirchi M, Masnavi A, Rahgozar M, Akbarian M. [Comparing quality of life between seniors living in families and institutionalized in nursing homes (Persian)]. Social Welfare Quarterly. 2011; 10(39):177-200.
  29. Rashedi V, Gharib M, Yazdani AA. [Social participation and mental health among older adults in Iran (Persian)]. Iranian Rehabilitation Journal. 2014; 12(1):9-13.
  30. de Graaf C, Kok FJ, van Staveren WA. Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. BMJ. 2006; 332(7551): 1180–1184. [DOI:10.1136/bmj.38825.401181.7C]
  31. Motamedi SA, Ezhey J, Fallah, P, Kiamanesh A. [The role of social support on life satisfaction, general health and loneliness among the elderly over 60 years old (Persian)]. Journal of Psychology. 2002; 6(2):115-133.
  32. Rezayi S, Manouchehri M. [Comparison of mental disorders between home owner residents and nurse homes elders (Persian)]. Iranian Journal of Ageing. 2008; 3(1):16-25.
  33. Darvishpoor Kakhki A, Abed Saeedi J, Delavar A, Saeed-OZakerin M. [Autonomy in the Elderly: A Phenomenological Study (Persian)]. Hakim Research Journal, 2010; 12(4):1-10.
  34. Heravi Karimoei M, Reje N, Foroughan M, Montazeri A. [Elderly abuse rates within family among members of senior social clubs in Tehran (Persian)]. Iranian Journal of Ageing. 2012; 6(4):37-50.
  35. Thomas P, Couegnas N, Hazif-Thomas C. Nursing Home and Elderlies’ Family: Questions about Semiospheres. Journal of Nursing & Patient Care. 2017; 1:1. [DOI:10.4172/2573-4571.1000107]
Type of Study: Research | Subject: Social
Received: 2017/11/10 | Accepted: 2018/03/11 | Published: 2018/06/22

References
1. United Nations. World population prospects, 2008 revision. New York: United Nations: 2010.
2. Han M. Health care of the elderly in Myanmar. Regional Health Forum. 2012; 16(1):23-28.
3. Findsen B, Formosa M. Lifelong learning in later life: A handbook on older adult learning. Rotterdam: Sense Publishers; 2011. [DOI:10.1007/978-94-6091-651-9] [DOI:10.1007/978-94-6091-651-9]
4. Mirzaei M, Shams Ghahfarokhi M. [Demography of elder population in Iran over the period 1956 to 2006 (Persian)]. Iranian Journal of Ageing. 2007; 2(3):326-31.
5. Statistical Centre of Iran. [Outset of the national population and housing census 2011 (Persian)]. Tehran: Statistical Centre of Iran; 2012.
6. Greaves CJ, Farbus L. Effects of creative and social activity on the health and well-being of socially isolated older people: outcomes from a multi-method observational study. Journal of the Royal Society for the Promotion of Health. 2006; 126(3):134–42. [DOI:10.1177/1466424006064303] [DOI:10.1177/1466424006064303]
7. Ollonqvist K, Palkeinen H, Aaltonen T, Pohjolainen T, Puukka P, Hinkka K, et al. Alleviating loneliness among frail older people–findings from a randomised controlled trial. International Journal of Mental Health Promotion. 2008; 10(2):26-34. [DOI:10.1080/14623730.2008.9721760] [DOI:10.1080/14623730.2008.9721760]
8. Crist, JD. Crist JD. The meaning for elders of receiving family care. Journal of Advanced Nursing. 2005; 49(5):485-93. [DOI:10.1111/j.1365-2648.2004.03321.x] [DOI:10.1111/j.1365-2648.2004.03321.x]
9. Murphy E. Social origins of depression in old age. The British Journal of Psychiatry. 1982; 141(2):135-42. [DOI:10.1192/bjp.141.2.135] [DOI:10.1192/bjp.141.2.135]
10. Yazdanpur F, Sam Aram E. [Effective factors on life quality of elderly in Khomein (Persian)]. Social Development & Welfare Planing. 2011; 2(6):45-63.
11. Gholizadeh A, Shirani A. [The relation between personal, family, social and economic factors with the rate of life satisfaction of aged people of Isfahan (Persian)]. Journal of Applied Sociology. 2010; 21(1):69-89.
12. Knodel J. Intergenerational Family Care for and by Older People in Thailand. Paper presented at the Conference on Shifting Boundaries of Care Provision in Asia: Policy and Practice Changes, Asia Research Institute; 2011 March 14-15; Singapore, India.
13. Drageset J, Natvig GK, Eide GE, Clipp EC, Bondevik M, Nortvedt MW, et al. Differences in health‐related quality of life between older nursing home residents without cognitive impairment and the general population of Norway. Journal of Clinical Nursing. 2008; 17(9):1227-36. [DOI:10.1111/j.1365-2702.2007.02132.x] [DOI:10.1111/j.1365-2702.2007.02132.x]
14. Salehi L, Salaki S, Alizadeh L. [Health-related quality of life among elderly member of elderly centers in Tehran (Persian)]. Iranian Journal of Epidemiology. 2012; 8(1):14-20.
15. Mokhtari F, Ghasemi N. [Comparison of Elderlys Quality of life and mental health living in nursing homes and members of retiered club of Shiraz city (Persian)]. Iranian Journal of Ageing. 2011; 5(4):53-63.
16. Abdollahi F, Mohammadpour RA. [Health related quality of life among the elderly living in nursing home and homes (Persian)]. Journal of Mazandaran University of Medical Sciences. 2013; 23(104):20-5.
17. Panah Ali A. [A comparison between the level of happiness among the elderly living at home and that of senior home residents (Persian)]. Iranian Journal of Ageing. 2011; 6(3):49-55.
18. Evangelista RA, Bueno A de A, Castro PA de, Nascimento JN, Araújo NT de, Aires GP. Perceptions and experiences of elderly residents in asylum. Revista da Escola de Enfermagem da USP. 2014; 48(spe2):81–6. [DOI:10.1590/S0080-623420140000800013] [DOI:10.1590/S0080-623420140000800013]
19. Boyle JS. Styles of ethnography. In J. M. Morse editor. Critical Issues in Qualitative Research Methods. Thousand Oaks, CA: Sage; 1994.
20. Van Maanen J. Tales of the field: On writing ethnography. Chicago: University of Chicago Press: 2011. [DOI:10.7208/chicago/9780226849638.001.0001] [DOI:10.7208/chicago/9780226849638.001.0001]
21. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology. 2006; 3(2):77-101. [DOI:10.1191/1478088706qp063oa] [DOI:10.1191/1478088706qp063oa]
22. Mertens DM. Research and evaluation in education and psychology. Thousand Oaks, London: Sage Publications: 2005.
23. Hemmati Alamdarlou G, Dehshiri G, Shojaie S, Hakimi Rad E. [Health and loneliness status of the elderly living in nursing homes versus those living with their families (Persian)]. Iranian Journal of Ageing. 2008; 3(2):557-64.
24. Momeni K, Karimi H. [The comparison of general health of the residents/non residents in the elder house (Persian)]. Iranian Journal of Ageing. 2010; 5(3):23-29.
25. Alipour F, Sajadi H, Forouzan A, Nabavi H, Khedmati E. [The role of social support in the anxiety and depression of elderly (Persian)]. Iranian Journal of Ageing. 2009; 4(1):147-165.
26. Iden KR, Ruths S, Hjørleifsson S. Residents' perceptions of their own sadness-a qualitative study in Norwegian nursing homes. BMC geriatrics. 2015; 15(1):21-28. [DOI:10.1186/s12877-015-0019-y] [DOI:10.1186/s12877-015-0019-y]
27. Hesamzadeh A, Maddah SB, Mohammadi F, Fallahi Khoshknab M, Rahgozar M. [Comparison of elderlys" quality of life" living at homes and in private or public nursing homes (Persian)]. Iranian Journal of Ageing. 2010; 4(4):66-74.
28. Ghasemi H, Harirchi M, Masnavi A, Rahgozar M, Akbarian M. [Comparing quality of life between seniors living in families and institutionalized in nursing homes (Persian)]. Social Welfare Quarterly. 2011; 10(39):177-200.
29. Rashedi V, Gharib M, Yazdani AA. [Social participation and mental health among older adults in Iran (Persian)]. Iranian Rehabilitation Journal. 2014; 12(1):9-13.
30. de Graaf C, Kok FJ, van Staveren WA. Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. BMJ. 2006; 332(7551): 1180–1184. [DOI:10.1136/bmj.38825.401181.7C] [DOI:10.1136/bmj.38825.401181.7C]
31. Motamedi SA, Ezhey J, Fallah, P, Kiamanesh A. [The role of social support on life satisfaction, general health and loneliness among the elderly over 60 years old (Persian)]. Journal of Psychology. 2002; 6(2):115-133.
32. Rezayi S, Manouchehri M. [Comparison of mental disorders between home owner residents and nurse homes elders (Persian)]. Iranian Journal of Ageing. 2008; 3(1):16-25.
33. Darvishpoor Kakhki A, Abed Saeedi J, Delavar A, Saeed-OZakerin M. [Autonomy in the Elderly: A Phenomenological Study (Persian)]. Hakim Research Journal, 2010; 12(4):1-10.
34. Heravi Karimoei M, Reje N, Foroughan M, Montazeri A. [Elderly abuse rates within family among members of senior social clubs in Tehran (Persian)]. Iranian Journal of Ageing. 2012; 6(4):37-50.
35. Thomas P, Couegnas N, Hazif-Thomas C. Nursing Home and Elderlies' Family: Questions about Semiospheres. Journal of Nursing & Patient Care. 2017; 1:1. [DOI:10.4172/2573-4571.1000107] [DOI:10.4172/2573-4571.1000107]

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