|Year : 2014 | Volume
| Issue : 1 | Page : 32-34
Assessment of subjective well-being status of elderly people in old age homes in Kolkata in relation to their perceived physical health and cognitive functioning
Jharna Bag1, Debashish Sanyal2, Liza Thankam Daniel1, Asima Chakrabarti3
1 Department of Psychiartic Nursing, Institute of Psychiatry, Kolkata, West Bengal, India
2 Department of Psychiatry, KPC Medical College, Kolkata, West Bengal, India
3 Government College of Nursing, Kolkata, West Bengal, India
|Date of Web Publication||3-Nov-2014|
Institiute of Psychiatry (COE), 7, DL Khan Road, Kolkata - 700 025, West Bengal
Source of Support: None, Conflict of Interest: None
Introduction: There is a limited data on the subjective well-being of elderly people living at old age homes in India. It is needed for planning better maintenance of physical health as well as cognitive function for their overall well-being. Materials and Methods: A descriptive survey was conducted. The data were collected from 50 elderly people who were selected by total enumeration sampling from two different old age home in Kolkata. They were assessed using Subjective Well-being Inventory and a self developed checklist for perceived physical health problems. Cognitive function was assessed by using Mini Mental State Examination. Results: More than half (52%) of the elderly people have reported high subjective well-being status. Regression analysis showed that perceived physical health problem (P < 0.001) and having children (P = 0.010) were statistically significant predictors of subjective well-being. Conclusion: In order to improve the quality of life of elderly people health workers should give more emphasis on psychosocial aspects of this population. Improved psychosocial aspects can increase perceived physical health hence subjective well-being.
Keywords: Elderly people, perceived physical health status, subjective well-being status, cognitive function
|How to cite this article:|
Bag J, Sanyal D, Daniel LT, Chakrabarti A. Assessment of subjective well-being status of elderly people in old age homes in Kolkata in relation to their perceived physical health and cognitive functioning. J Mental Health Hum Behav 2014;19:32-4
|How to cite this URL:|
Bag J, Sanyal D, Daniel LT, Chakrabarti A. Assessment of subjective well-being status of elderly people in old age homes in Kolkata in relation to their perceived physical health and cognitive functioning. J Mental Health Hum Behav [serial online] 2014 [cited 2020 Aug 11];19:32-4. Available from: http://www.jmhhb.org/text.asp?2014/19/1/32/143888
| Introduction|| |
Life expectancy worldwide has risen on average by 4 months each year since 1970.  Because more people are living longer, health professionals will be expected to help the geriatric population to make these added years to their lives healthy and productive. WHO report of 2004 states that 236 elderly people per 10,000 suffer from mental illness mainly due to stress, heart disease, stroke and cancer.  The process of aging also tends to create psychological and social problems for the individual and society. In developing country, where seriously impaired older persons live in the community, in almost all cases they are cared by a spouse or grown-up children. However, with the urbanization, the joint family system is gradually moving towards nuclear families and elderly are left alone and they move to an institution. But still a large percentage of today's aging population continues to live independently despite having variety of chronic health problems.  Careful assessment of aging person's perception of his or health, health practices, and knowledge of safety factors affecting their own health is an important part of primary care in all settings, especially for family practitioners and nurses.  Indian society is moving towards an industrialized urban society where changes are causing adverse effects on subjective well-being of aged people.  So, it is more important to study about subjective well-being of senior citizens living in old age homes.
Optimism was found to be a predictor of both subjective and psychological well-being.  Therefore assessment of the aging person's perception of his or her health is required as type of perception has an effect on well-being. Thus, the study was undertaken with the following objectives (a) To find out the perceived physical health problems of the elderly people; (b) To screen cognitive function of the elderly people; (c) To identify the subjective well-being status of the elderly people; and (d) To predict the relation of subjective well-being with perceived physical health problem, cognitive function and selected demographic variables.
| Materials and Methods|| |
A nonexperimental approach as well as descriptive survey was conducted to collect the data after taking the written consent from the participants. The data were collected from 50 elderly people who were selected by total enumeration sampling from two different old age homes which was selected conveniently from Kolkata. A structured questionnaire was used to obtain information about demographic data. Perceived physical health problems were assessed by a self developed checklist which had two main areas, i.e. physical and psycho-social, with the maximum score was 92. Reliability of the tool was established by using test retest method (r = 0.95). Subjective well-being of elderly people was assessed by SWBI standard three point rating scale which had 40 items with the maximum score of 120. Cognitive function was assessed by using Mini mental status examination which is a standardized scale; Maximum total score of this scale is 30. Total time taken to collect the data from each subject was approximately 1½ h.
| Results|| |
Mean age of the elderly people living in old age home was 74.5 ± 6.7 years and the mean duration of stay was 6.4 years. Majority of them were female (74%). Most of the elderly people followed Hindu religion (96%). 48% of the elderly people had education of graduation and above. 66% of the elderly were widows, less than half (42%) of the elderly people were getting pension. More than half (58%) of the elderly people had children. Most of them (68%) had given the reason for living in old-age home as 'no one to take care'. 78% expressed that they had been suffering from known diseases; the commonest diseases are hypertension (52%) and arthritis (80%).
Perceived physical health problem, cognitive function and subjective well-being
As shown in [Figure 1], one third of elderly were in category I, which means they had mild perceived physical health problems. 24% were in category II that means they had moderate perceived physical health problems, 38% of the elderly people were in category III, and means they perceived severe physical health problems.
As shown in [Figure 2], 86% elderly were cognitively unimpaired, 12% were mildly impaired and 2% were severely impaired. The mean score of cognitive function of the elderly people was 26.44 ± 2.99. As shown in [Figure 3], 52% elderly people had high well-being status, among them 36% were females and 16% were males and 40% had moderate well-being status. The mean scores of total items were 79.40 ± 12.96.
As shown in [Table 1], R2 value of 0.408 indicated that 40% of the subjective well-being in variance was significantly explained by predictors like score of perceived health problem (P = 0.000*) and having children (P = 0.010*). Other variables like age, gender, source of income, education and duration of stay had no influence on subjective well-being.
| Discussion|| |
There is consensus among many gerontological studies that high subjective well-being among the elderly people is mainly a result of adaptation, emotional regulation, and accommodative strategies such as rescaling goals and adjusting aspirations to the given situation. In this paper we aimed to see the relation of subjective well-being with perceived physical health problem, cognitive function and selected demographic variables.
In the present study it was found that there was no association between cognitive function and subjective well-being of elderly people, this result is incongruent with another study which was done in China that shows a higher level of cognitive abilities is positively associated with good subjective well-being. 
More than half (58%) of the elderly people reported that they had children and regression analysis showed that having children is a significant predictor for good subjective well-being. Having children can increase the perceived social support of elderly people and literature shows that low social support is associated with poor self rated health.  Other than having children, subjective well-being was not predicted by any other variables like education, gender, age, source of income, duration of stay in old age home etc., But, this finding was incongruent with another study conducted in India in which subjective well-being of the institutionalized elderly was predicted by age, education and financial support.  38% of the elderly people reported severe perceived physical health problem and severe perceived physical health problem appears to be a sensitive predictor for low subjective well-being. This finding is similar to the other study which shows that poor perceived health status rather than the presence of a chronic condition is detrimental to individual's subjective well-being. 
This study was limited in many ways. Firstly randomization of the subjects could not be done and secondly sample size was small due to limited time period. However in the absence of more objective measures, perceived health status may be a suitable measure of health status in epidemiological studies.
Therefore, it is recommended to conduct a future study to find out the subjective well-being in a larger setting. In order to improve the quality of life of elderly people health workers should give more emphasis on psychosocial aspects of this population because improved psychosocial aspects can increase perceived physical health hence subjective well-being.
| Acknowledgements|| |
Author is thankful to West Bengal University of Health Science for their support and permission to conduct this research work. Investigator is indebted to all elderly people who were participated in this study.
| References|| |
Lalitha K. Health aspects of elderly: A global issue. J Krishna Inst Med Sci 2012;1:2-3.
Rupali SM. An exploratory study to assess the physical health and incidence of limitations in activities of daily living of senior citizen residing in selected slums of Pune city. Nightingale Nurs Time 2007;3:16-7.
Ayranci U, Ozdag N. Health of elderly: Importance of nursing and family medicine care. Internet J Geriatr Gerontol 2005;3:3.
Patil SS, Itagi SK, Khadi PB, Havaldar YK. Subjective well-being status among institutionalized and non-institutionalized senior citizens. J Sociol Soc Anthropol 2013;4:251-7.
Ferguson SJ, Goodwin AD. Aging and human development, Optimism and well-being in older adults: The mediating role of social support and perceived control. Int J Aging Hum Dev 2010;71:43-68.
Caetano SC, Silva CM, Vettore MV. Gender differences in the association of perceived social support and social network with self-rated health status among older adults: A population-based study in Brazil. BMC Geriatr 2013;13:122.
[Figure 1], [Figure 2], [Figure 3]