Mental health problems in adults in old homes of Pakistan

1. Mental Health Problems In Older Adults
Living In Old Homes

2.  Globally, the population is ageing rapidly. Between 2015 and 2050, the proportion
of the world’s population over 60 years will nearly double, from 12% to 22%.
 Older adults, those aged 60 or above, are at risk of developing mental disorders
depending on their circumstances.
 Many older adults living in Pakistan experience significant level of physical, social
and psychological health problems, leading to increased burden of chronic
diseases, disabilities, and psychiatric illnesses.
 Elderly populations above 55 years with depression have four times higher death
rate than those without depression (WHO Report).
 Mental health has an impact on physical health and vice versa.
 Mental health problems or psychological problems are under-identified by health-
care professionals and older people themselves, and the stigma surrounding
mental illness makes people reluctant sometimes to seek help.

3. The older adults who live in old homes or shelter
homes develop more mental health problems than
the physical health problems.

4.  In Pakistan, depression, anxiety and dementia are the most common psychiatric
disorder among elderly population that cannot be neglected (Bhamani, Karim&
Khan, 2013).
 In United States, the rate of prevalence of depression is high as 40% where as in
Pakistan it is as high as 66% among elderly (Javed& Mustafa, 2013).
 Health care system in Pakistan lacks geriatric clinics and they are treated by
general or family physicians (Ganatra, Zafar, Qidwai, Rozi, 2008).
 Health care professionals lack training to deal with special issues of this age
group (Qidwai & Ashwaq, 2011).
 A national policy for the promotion of better health of the elderly was designed in
1999, and it involved training of health care professionals in geriatrics and other
areas, but implementation is yet to be seen (Subzwari & Azhar, 2010).
 The older adults with evidence of mental health problems are less likely than
younger and middle aged adults to receive mental health services (Karel, Gatz &
Smyer, 2012).
 There has been no population based study on mental health of older adults who
live in old homes conducted in Pakistan (Bhamani, Karim& Khan, 2013).

5.  The trend of leaving parents in old homes has increased since 2001. Besides, Dar-ul-
Affiat, there are more than nine private old homes in Rawalpindi and Islamabad.
 “Older adults residing in an old homes come with many psychological problems like
depression and anxiety but staff in older homes try their best to provide them basic
facilities and help them recover” said Capt. (retired) Ruqia Bibi, who takes care of old
people at Dar-ul-Affiat.
 While people may hold firm to the belief that ‘abandoning’ a parent is against social
and religious mores in Pakistan, there is one advantage to such institutions. “They get
a chance to socialise with people of the same age bracket,” says Dr Rizwan Taj, who
working as psychiatrist and often visit Edhi Home Islamabad.
 “Some of the elderly people come with psychosomatic disorders. They assume they
are not well. We schedule their meetings with psychiatrist, who help them recovering.
After sometime they start feeling normal,” said a nurse in Dar-ul-Affiat.

6.  Dr. Taj (psychiatrist) said that “old homes try their best to provide elderly people good
environment and basic facilities and necessities of life. Old people who think they have
been dumped and they are useless start feeling better after interacting with other
people in old homes.”
 Dr Hussain (psychiatrist) said according to his experience people who are living in old
homes more than two years are living healthy life as compared to their life with family.
They do miss their families but its not like they feel depressed or isolated.
 Majority of the elderly people who were interviewed in the old homes told that they are
more happy in old homes than their own homes.
 They said they are treated well here, they get good food on time, they don’t have to
worry about anything. They do not wish to go back to their families. However they all
miss their families and wish to meet them.

7.  The older adults who are living in old homes in Islamabad and Rawalpindi seem to be
happy and satisfied. They told about their medical conditions they had when they came
and how they recovered with the help of management. It is noted that most of them
were in good mental and physical health.
 The old homes are found to be clean and organized. The people had all the facilities.

8.  It is noted the elderly people and the staff members have a friendly relationship. They
have freedom to do anything. The staff and people who are living in old homes
informed that they participate in recreational activities. Two of them were busy in
gardening with one staff member. Some of them are now assisting staff members to
help new people in settling in.

9.  They do miss their families and get upset on occasions when no one comes to
meet them from their families. But during the interviews it was noticed that they
kept referring old homes as their permanent home. Most of them said that they do
not wish to go back to their homes and would spend whole life in old home. They
said that the management fulfills their needs without any demands. The staff of old
homes look after them very well and provide all kinds of assistance.
 The doctors’ information tell us that it is likely that these people become victims of
depression, anxiety and dementia easily considering their circumstances back in
their homes however the old homes staff try their best to look after them and treat
them as family members.
 The information collected through interviews is not consistent with the information
noted in literature review.

10.  The hypothesis of this research documents is “The older adults who live in old
homes or shelter homes develop more mental health problems than the physical
health problems.” The information collected during the research does not support
the hypothesis. The elderly people/older adults seem to be in good mental and
physical health.
 Their stories tell that they were victims of mental health problems before coming
to old homes. After they spent some time in old homes they realized that they are
in better place and started recovering from different diseases.
 They appreciate the management of the old homes for looking after them and
providing them all facilities. They also appreciate the staff members who assist
them in everything on daily basis.
 The conclusion of this research does not favor the hypothesis yet give a new
statement; “the old homes help older adults in providing them shelter and
recovering from different mental and physical problems.”