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| ORIGINAL ARTICLE |
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| Year : 2023 | Volume
: 13
| Issue : 1 | Page : 10-14 |
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The risk of abuse and mental health status of elderly residing in urban communities of Delhi
Sumity Arora1, Raminder Kalra2
1 Department of Mental Health Nursing, PD College of Nursing, Deen Dayal Upadhya Hospital, New Delhi, India
2 Department of Mental Health Nursing, HFCON, Delhi University, New Delhi, India
| Date of Submission | 09-Nov-2022 |
| Date of Decision | 13-Jan-2023 |
| Date of Acceptance | 16-Jan-2023 |
| Date of Web Publication | 24-Feb-2023 |
Correspondence Address:
Dr. Sumity Arora
PD College of Nursing, Deen Dayal Upadhya Hospital, Harinagar, New Delhi – 10069
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/cmrp.cmrp_114_22
Background and Objectives: Elderly is a vital part of the population of any country who owe respect and attention equally to any other section of the population. The present study was aimed at assessing the risk of abuse amongst the elderly, mental health status of elderly and correlation of abuse with their mental health of the elderly residing in urban communities of Delhi.
Materials and Methods: This study was cross-sectional and descriptive conducted on 270 elderly chosen by cluster sampling method residing in the urban community of South Delhi, India. Sociodemographic data, elder abuse and their mental health were assessed by sociodemographic tool, Hwalek-Sengstock Elder Abuse Screening Test and Self Reporting Questionnaire (SRQ-20), respectively.
Results: Online Social Science Statistics package was used for analysis of the study. In the present study, majority of the participants were male and were in the age of 61–70 years. Approximately 50% of elderly were uneducated and not working. The majority (63%) of the elderly reported a mild risk of abuse. The majority of the participants reported altered mental health, i.e., SRQ >7. In the study findings, elder abuse and mental health were significantly associated (at P < 0.05) with each other.
Conclusion: The study showed that elder abuse and mental well-being of elderly are related to each other and it requires appropriate involvement of concerned authority to protect elderly living in the community of Delhi, India.
Keywords: Abuse, Delhi, elderly, mental well-being
How to cite this article:
Arora S, Kalra R. The risk of abuse and mental health status of elderly residing in urban communities of Delhi. Curr Med Res Pract 2023;13:10-4 |
| Introduction | |  |
As per the World Health Organization (WHO) report (2022), with rapid aging elderly abuse is expected to increase every year, and every sixth elderly faces abuse in one or another form.[1] In India, the current proportion of the elderly population is 8% and is projected to rise to 12.4% by 2026 and 19% by 2050.[2] Mental and neurological problems account for 6.6% of disability-adjusted life years and 17.4% of years lived with disability amongst the elderly.[3] Psychological agony and despair would result in increased morbidity and mortality in elderly. Evidence suggests that elder abuse is also associated with psychological distress, which warrants more attention. In recent years, research studies and clinical cases have begun to document the associations between elder abuse and psychological distress.[4] Despite old age and increased vulnerability possibly inherently lending themselves to negative emotional distress such as depression, anxiety and loneliness, elder abuse is a stressful life event that may lead to pronounced and sustained psychological distress in older adults. Whereas severe psychological distress experienced by older adults may result from abuse, less is known regarding the mechanisms that may increase the risks of abuse amongst older adults with greater levels of psychological distress in the first place. An improved understanding of these relationships is critical to devise effective preventions and interventions amongst rapidly growing ageing populations.[4] In India, as per the study by Gupta,[5] older persons who experience physical abuse suffer more psychological and other health problems such as depression, suicide and other health problems. Community-based studies conducted amongst the elderly in India have reported a 'depression prevalence rate ranging from 8.9% to 62.16%'.[6] The mental health of the elderly has an influence on their physical health.[7] Individuals with depression have a 1.52 times higher chance of mortality than the general population.[8]
Elderly abuse has been recognised as a problem in an urban community in India. In addition, an association of elderly abuse with mental health is the area to be explored and discussed so that appropriate intervention can be planned effectively. Hence, the objectives of this study were: to study the aspects relating to the elderly in an urban community with a focus on abuse and mental health and to correlate the elderly abuse with the mental health of the elderly living in the urban community of Delhi, India.
| Materials and Methods | | |
The study was conducted in the urban community of the South Delhi district in Jamia. This study was a descriptive and cross-sectional study. A cluster-sampling method was used. Formal permission was taken from the concerned authority to collect the data. A convenient sampling method was used to select community area. After that, simple random sampling was used to select the houses in selected community. Data were collected after obtaining verbal informed consent and one who fulfilled the inclusion criteria from each house filled out the questionnaire. Confidentiality was assured to the sample.
Data were collected over 4 months. The sample size was 270. The inclusion criteria were: age of more than 50 years, ability to read and willingness to participate in the study.
Sociodemographic characteristic was assessed using self-structured questionnaire. The questionnaire included questions on age, education, occupation, duration of marriage and family income. The Hwalek-Sengstock Elder Abuse Screening Test was used to assess elder abuse. The Hwalek-Sengstock Elder Abuse Screening Test is a standardised short (15 items) questionnaire to screen for persons who may be at risk for abuse. It is helpful to identify abused or neglected elders or persons at risk. It is a widely accepted standardised tool used in the community.
The mental health status of the elderly was assessed using a self-reporting questionnaire or Self Reporting Questionnaire (SRQ)-20. It was developed by the WHO as a screening tool for the assessment of common mental disorders.[9] It was primarily developed for use in primary healthcare settings. It consists of 20 yes/no type questions to assess the presence of neurotic symptoms (anxiety, depression and psychosomatic). It involved asking whether the elderly had experienced any of the 20 listed symptoms in past 4 weeks. The questions were based on symptoms such as headache, loss of appetite, feeling of tiredness, digestion problems, anxiety, nervousness, loss of interest, difficulty in making decisions, unhappiness and suicidal thoughts.
The score of eight or more in the questionnaire is interpreted as unhealthy.
Analysis
Information collected was analysed with the Social Science Statistics package available online. A descriptive analysis, included frequencies, percentages, ranges, means and standard deviations. Paired t-test was used to compare the difference between a paired t-test was used to compare the mean of different abuse and mental health.
| Results | | |
Demography
The characteristics of the study population are shown in [Table 1]. A total of 270 elderly participated in the study. More than half (53.3%) were 61–70 years of age, and the majority (51.5%) were not educated. More than half (63.4%) of the elderly stayed in a joint family. Almost one-third (68.2%) were unemployed.
Elder abuse
[Table 2] shows the frequency and percentage distribution of risk for abuse amongst elders. It shows that 63.2% of the elder reported one or the other types of abuse, i.e., score ≥1, showing that the elderly in urban is at mild risk for abuse in life.
Mental health
[Table 3] shows frequency and percentage distribution of mental health status amongst elders. It shows that two-third (66%) elderly had poor mental health with score of more than seven in SRQ.
Correlation between elder abuse and mental health
As shown in [Table 4], the mean score on the elder abuse scale was 3.8 (2.97), and the mean score on the SRQ scale was 8.47 (3.9). A positive correlation (0.53) was found between the two variables. Paired 't'-test was conducted to compare the mean score of abuse and mental health of the elderly. It showed a significant association (P < 0.05) between abuse and mental health, thereby indicating that the elderly who experienced abuse had poor mental health.
[Table 5] shows the item-wise distribution of abuse amongst the elderly. A majority (77.8%) of elderly reported that they do not have anyone who spends time with them and take them shopping or to the doctor. Nearly, half (43.7%) felt sad or lonely often. A majority (73%) do not have enough privacy at home.
| Discussion | | |
The present study attempted to understand the elderly abuse and their mental health in the urban community of Delhi. The study also correlated the abuse with the mental health of the elderly. The major highlight of the study was that it was a community-based study, all the elderly were visited in their houses, and a complete assessment was done.
The findings of the study reveal that the majority (90%) of the elderly are at risk for abuse. The findings are similar to the other studies[10],[11] which reported that elder abuse is an issue and concern in Indian cities and needs intervention at the local level and government levels.
The majority of the elderly have altered mental health in the present study. The findings are in line with other studies.[12],[13]
In the present study, mental health was significantly associated with abuse in the elderly. The risk of poor mental health was higher amongst the elderly who reported abuse. This support findings from other studies[14] that considerably recognised the link between abuse and mental health. Elder abuse amongst older adults in India is associated with poor physical health, poor mental health and healthcare utilisation, emphasising the need to consider elder abuse in various physical and mental health contexts. Pengpida and Peltzer[15] highlighted that elder abuse was significantly positively associated with poor mental health and poor well-being (low life satisfaction, not happy, insomnia symptoms, depressive symptoms, loneliness, neurological or psychiatric problems and lower self-rated health status), poor physical health (bone or joint disease, physical pain, gastrointestinal problems, incontinence, functional disability, underweight and persistent headaches), fall and healthcare utilisation.
There are some policy implications derived from the present study findings that further expansion of abuse clinics is required to reach the elderly needs in the community. In addition, age-specific support services can be provided to family members to help the elderly at home. The altered mental health in the elderly suggested additional attention and support in the additional attention and support in mental health. The findings of the present study have implications for clinical practice. Families play a complex role in elderly abuse and their mental health. They provide assistance in multiple areas such as direct care, monetary support and help the elder at home. On the practical level, strategies to improve communication between families and health providers can be better developed if primary care physicians receive adequate training in elderly abuse screening and routine management.
Limitations of the study
The number of male participants exceeded that of the females in the study. The abuse history was not taken in detail.
| Conclusion | | |
There are mental health issues in the elderly that are associated with their abuse. The mental health of the elderly should be checked regularly, and communities should be sensitised by awareness programmes. Longitudinal studies can be done to gain a better understanding of factors that influence the relationship between family and elderly abuse.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]
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