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Journal of the Academy of Hospital Administration

A Study on the Need to Establish a Geriatric Set Up in a Teaching Hospital

Author(s): Sunita Saldanha*, Libert Anil Gomes**, Sanjeev Rai***

Vol. 15, No. 2 (2003-07 - 2003-12)

Abstract:

Eighty Five geriatric inpatients aged 60 years and above were interviewed to know the adequacy of physical structure, organization and medical care in a teaching hospital where significant number (17%) of geriatric population is utilizing the services provided by the hospital.

Majority (61%) of the geriatric patients felt the need for a separate set up. They felt the need of facilities such as, telephone, television, music, prayer hall, dining hall for their social and spiritual needs.

Most of them (78%) were satisfied with clinical and supportive service, Majority (90%) of them did not face any problem in the physical facilities provided except non-slippery floor and cot adjustments.

There is a need for a separate geriatric unit in a teaching hospital utilized by significant number of geriatric population. However modification of the existing facility would at least result in a better care being provided to geriatric population.

Key Messages:

  • Geriatric population is at high risk of disease and high risk of utilizing medical services.
  • There is a need to provide adequate physical facilities, if possible a separate set up to support their special needs.

Keywords: Geriatrics, health need, health care, service utilisation.

Introduction

Population aging has immense implications for all countries. In the 21st century one of the biggest challenges will be how best to prevent and postpone disease and disability and to maintain the health independence and mobility of an aging population.1

There are more than 76 million elderly people in the country who constitute 7.7% of India's population. By the year 2020, the estimated population of the elderly will be 142 million or about 11% of the country's population.2

There are predictions of an increase in geriatric population especially in Asia in the coming decades. Hospital utilization by geriatric patients will also increase.3

The health care in India today is incapable of responding to the needs of the elderly males and females even at the primary level and even doctors are not aware of the special needs of the elderly. So while providing health care to geriatric population under general institutional set-up it is very important to provide adequate physical facilities which will support their special needs and will help to overcome their physical disabilities.4

It is high time nursing care of the elderly to be considered as specialty where the physical, emotional, spiritual needs of an elderly individual can be met in a highly dedicated manner.5

This study was undertaken in a teaching hospital, where significant number of geriatric population are utilizing the services provided, to know the adequacy of physical structure and medical support given to them and thereby the requirement of separate specialty.

Materials and Measurements

85 geriatric in-patients aged 60 years and above were selected by purposive sampling method and interviewed by giving a questionnaire, which included adequacy of the physical structure, organisation structure and type of medical care rendered. The obtained data was analysed. Patients who were re-admitted during the study period, who were not able to communicate because of their disability and who were not willing to participate in the study were excluded.

Utilization of the existing facilities was studied by retrospective study from in-patient statistics.

Results:

In patient Admissions of Different Age Groups

Figure 1 missing

This figure shows that significant number of geriatric patients are utilizing the services provide by the hospital.

Table 1: Clinical and Supportive Services

S. No. Items Satisfied Not Satisfied Undecided Mean % Mean
    Total No. % Total No. % Total No. %    
1 Opinion regarding admission / discharge Procedures 51 60 16 18 18 22 1.4 70
2 Opinion regarding Nursing Care 63 74 9 11 13 15 1.6 80
3 Opinion regarding Doctors Care 65 77 5 6 15 17 1.7 85
4 Opinion regarding ward Boys / ayahs 42 49 9 11 34 40 1.4 70
5 Opinion regarding diet provided 47 55 24 28 14 17 1.3 65
  Total 54 63 13 15 18 22 1.5 75

Table 1 reveals that the majority of the patients were satisfied with the clinical and supportive services provided (mean score 75%).

Table 2: Location

S. No. Items No Difficulty Minimum Difficulty Maximum difficulty Mean % mean
    Total No. % Total No. % Total No. %    
1 Difficulty in Locating the wards after Admission 64 75 16 19 5 6 1.7 85
2 Difficulty in going around various dept.'s for investigations 75 88 8 9 2 3 1.9 95
  Average 70 82 12 14 4 5 1.8 90

Table 2 reveals that majority of the patients (i.e. 82%) did not face any difficulty in locating the wards as well as going around the various department after admission.

Table 3: Physical Facilities

S. No. Items Positive
Response
% Negative
Response
%
1 difficulty in climbing steps 55 65 30 35
2 Sufficient space around the bed 60 71 25 29
3 Difficulty in walking over the ward floor 34 40 51 60
4 Convenience of bedside stool provided 52 61 33 39
5 Comfortability of wheelchair and stretchers provided 82 97 3 9
6 Adequacy of wheelchairs and sretchers in number 49 58 36 42
7 Requirement of cot adjustments 65 77 20 23
8 Requirement of curtains beside the bed for privacy 41 48 44 52
  Mean Score 55 65 30 45

Table 3 reveals that the majority of the patients were happy with the physical facilities provided. 77 % felt the need of cot adjustments and 60% faced difficulty in walking over the ward floor.

Table 4: Physical Environment

S. No. Item Positive
Response
% Negative
Response
%
1 Adequacy of lighting Provided 77 91 8 9
2 Noise surrounding the stay area 55 65 30 35
  Mean Response 66 78 19 22

Table 4 reveals that the majority of the patients were happy with the physical environment

Table 5: Emotional Support

S. No. Item Positive
Response
% Negative
Response
%
1   42 49 43 51
2   56 66 29 34
  Mean Response 49 57 36 43

57% of the patients felt the need of a emotional support by social worker/ relative.

Table 6: Other Facilities

Items Yes No
  Total No. % Total No. %
a) Need of telephone service 62 73 23 27
b) Need of reading room 20 24 65 76
c) Need of prayer hall 60 70 25 30
d) Need of television and music 50 58 35 42
e) Need of dining room 52 61 33 39
Hot water facility for bathing 83 98 2 2

From the table it can be seen that many of the patients felt the need of telephone service, a prayer hall, television and music and dining room facilities attached to their ward.

Conclusion

There is a large number of geriatric population utilizing the existing services and facilities provided by this teaching hospital. While studying the need of the elderly it was found that the majority of the geriatric patients were satisfied with the clinical and supportive services and the physical facilities. But they felt the need of cot adjustments and non-slippery flooring, social and emotional needs.

The number of geriatric patients visiting and utilizing the existing services shows that separate geriatric unit will be well utilized and would result in better care being provided to the geriatric population. Since this hospital is already well established, it may not be feasible to plan a new department. However, modification in the existing facilities and fulfilling their social and emotional needs would result in better care to the geriatric population.

References

  1. World Health Report, 1998
  2. Manju Nandi. Need for speciality nursing care for senior citizens. Geriatric Update by O.P. Sharma 1999:122-123
  3. Tan Poo Chang. Implication of changing family structure on old age support in the ESCAP region. Asia Pacific Population journal 1992,Vol.7,No:2:49-66
  4. Dr Kalyan Bagchi. Understanding the elderly. Health action:April1999,Vol.12,no:4:16-17
  5. D.J.Doheshry. Unmet needs in support services. Hospital Management International 1994:314

* Dept. of Hospital Administration, Fr. Muller Medical College, Mangalore - 575002
** Asst. Professor, Dept. of Hospital Administration Fr. Muller Medical College, Mangalore - 575002
*** Professor and H.O.D. Dept. of Pediatrics, Fr. Muller Medical College, Mangalore - 575002

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