Theses (MSc. Public Health)

ntroduction: Malaysia is postulated to become an aging nation by 2030, where the elderly population above 60 years old would reach 15% of the total population. The objective of this research is to understand the needs for long- term elderly care facility from the residents’ family member’s perspectives, as they are the decision makers. It is timely to gather evidence in Sarawak as there is no study done to-date. Methods: A qualitative, inductive, exploratory research design is applied in this research. In-depth interviews were conducted with family members of the residents of long-term elderly care facilities. They were recruited via purposive sampling from the researcher’s network. Saturation occurred at 8th participant. Data was analysed using thematic content analysis. Results: 5 main themes and 16 sub-themes were derived in 5 phases, namely Phase 1 (Challenges in caring for elderly family member), Phase 2 (Decision making to transfer to long-term elderly care facility), Phase 3 (Criteria for selecting long-term elderly care facility), Phase 4 (Experience at long-term elderly care facility) and Phase 5 (Expectation to improve quality of care). Space, hygiene and environment, location and distance from home and cost have been reported as important criteria for family members, and expectation to improve on service and facility have been outlined. Conclusion: Space, hygiene and environment, location and distance from home and cost are deemed important considerations for family members when choosing long-term elderly care facilities. Policy makers can consider expanding scope of government healthcare services to home visits and provide transportation to address the challenges faced by family members. Social and Welfare Department could encourage facility operator to register their business with the authority, as a mean to evaluate and accredit the standard of care to cover processes, procedures, facilities, and manpower. Guidelines for registration should be concise and cover core aspects and application for registration be made swift and efficient. Keywords: Elderly, nursing home, aged care, demand

Introduction: There is an unprecedented increase in the population of the elderly globally, and Malaysia is anticipated to become an ageing nation in 2030. Maintaining health, social participation, reducing institutionalization, and improving quality of life of the elderly are public health challenges of the 21st century. Quality of life among elderly in Elderly Homes in Malaysia is under researched. Objective: To determine the level of quality of life and its associated factors among the Elderly in Elderly Homes in Kuala Lumpur. Methodology: This was a cross-sectional study among 203 residents aged 60 years or more in eight randomly selected Elderly Homes in Kuala Lumpur in September 2014. Stratified simple random sampling was used to select participants. Study instruments included World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF), Geriatric Depression Scale, Multidimensional Scale for Perceived Social Support, and a questionnaire for Socio-demographic variables. Data collection was by face to face interview. Univariate and Multivariate analysis were used to determine associations, and P-value <0.05 was considered statistically significant. Results: The mean score of quality of life was 58.8 (±9.9), and 52.7% of respondents had poor quality of life. Females, those with lower level of education, poor socioeconomic status, less physically active, no outdoor activity, lived in ward accommodations, lived in a home for less than two years, those with hypertension, diabetes, history of stroke, hearing impairment, visual impairment, dental problem, chronic pain, falls, hospitalization, arthritis, depression, co-morbidity, poor self-rated health, those dissatisfied with their health and those with low levels of social support were more likely to have poor quality of life (P-value <0.05). Predictors of poor quality of life included level of education, socio-economic status, hearing impairment, visual impairment, chronic pain, depression, self-rated health, and social support. Conclusion: To attain optimal quality of life among the elderly in elderly homes, such institutions and policy makers have to take into account the multiple factors that affect quality of life in such homes. Better accommodation, health and welfare services, increase in physical activity, social support, public awareness of the challenges and ways to improve quality of life of the elderly, are actions that could yield positive results. Keywords: Elderly, Elderly Homes, Quality of Life, Kuala Lumpur.