Institutionalization of the Aged
Dr. Sr. Severine Menezes SAP
M.S.W, D.Coun, M.A, M.Phil, M.S, PGDHR, Ph.D
Sisters of St.Ann of Providence
Mangalore
Continues
throughout
life and
until death
Begins at
birth – at
the time of
conception
Not an
event but a
process
social
phenomenon
rather than
physiological,
Inevitable and
irreversible
process
a socially
constructed
concept
considered
as a social
reality.
As per the WHO guidelines people 60-74 years of age
are called elderly and those between 75 and 85+years of
age as old. The world is rapidly aging: the number of
people aged 60 and over as a proportion of the global
population will double from 11% in 2006 to 22% by
2050.



India is in the teeth of a demographic transition.
Its elderly population is 7.5 percent of total population
(seventy five millions).
The older population which is 56.7 millions in 1991
began growing to over 76 million by the year 2001 and
137 million in 2021.
1.
2.
a.
b.
Government old age home
Private Home for the aged
Unpaid/Non-profit old age home
Private Paid old age home
1.
2.
3.
4.
a.
b.
c.
d.
e.
f.
g.
Changes in Social Contact
Loneliness
Health Problems
Emotional Instability
Anxiety and Fears
Sadness and Depression
Anger and Irritability
Apathy
Jealousy
Self Neglect
Guilt
5.
6.
7.
8.
Adjustment Problems
Lack of Social Support
Forced Lifestyle
Lack of interest in the surrounding

Statement of the problem: The statement of the
research problem is ‘Institutionalization of the Aged.’
The present study is an attempt to identify the reasons
to get into institutions for the elderly, life of the
elderly in the institutions and the challenges faced by
them in these institutions.
The theoretical approach assesses that age is socially constructed
and one aim is to deconstruct superficial and biased knowledge
of ageing.
A) Biological Theories.

Accumulative-Waste Theory

Wear-and-Tear Theory

Somatic Mutation Theory

Error Accumulation Theory
B) Non Biological theories.

Disengagement Theory



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Selectivity Theory
Continuity Theory
Modernization Theory
Activity theory: Active ageing turns into successful ageing which is to be
achieved by denying the onset of old age and by replacing those
relationships, activities, and roles of middle-age that are lost with new
ones in order to maintain activities and life satisfaction.
1.To analyze the reasons for institutionalization of aged
persons.
2.To study and understand the life of the aged within the
institutions.
3.To assess the degree of respect, security and belongingness
experienced by the aged within these institutions.
4.To study the impact of institutionalization on the aged.
5.To assess the ability of the aged to cope with the problems
and stresses in the institutions.
The present study is carried on in Mangalore city from 09
Homes for the aged out of which 07 are private and 02 are
run by the Trust. There are no Homes run by the
Government in the city. Out of the nine Institutions for the
aged, only three are charity based and the others are paid.
All the residents of Home for the Aged in Mangalore city
are included in the study. There are 842 elderly in 09
Institutions, out of which 300 respondents are selected for
the research study.

Sampling Design
Simple random sample is used, because in this
sample each and every individual of the population
has an equal chance of being included in the sample.
To obtain the numbers that could represent the total
population, the researcher calculated the total number
of residents with 35 percent of the respondents. The
total sample size was 296. For the purpose of the study
the researcher took up 300 samples.
Inclusion Criteria
1.
2.
3.
4.
5.
The respondents include those who are 60 years of age
and above.
The respondents living in the institutions situated in
Mangalore city.
The respondents include both male and female residing
in the institutions.
The respondents who can comprehend instructions.
The respondents who are willing to participate in the
study.
Exclusion Criteria
1. It excludes those respondents who are not in
the Institutions.
2. It also excludes those respondents who have
the history of mental and physical disability
like hearing impediment, terminal illnesses,
etc.
3. It excludes also those who are seriously ill
or bedridden people.
Pilot Study
A Pilot study was conducted to assess
the efficiency of the tool of data
collection before arriving at the final
tool which helped in altering the tool
so that the researcher was prepared to
foresee the possible difficulties.
Research Design
The present study is an attempt to obtain and
assess the information concerning situation
and the challenges faced by the elderly in the
institutions for the aged. Therefore the study
carried out by the researcher using the
descriptive design.
Data Collection
Data is collected from both Primary and
secondary sources of Data.
Primary data is collected through the personal
interview method with the tool of interview
schedule.
Secondary source of data is collected through
books, journals, articles published in various
books and magazines.
Tools and techniques
1.
2.
3.
4.
5.
6.
Interview Schedule.
Measurement of Scales: Lawton MP and Brody EM (1969)
developed
Instrumental Activities of Daily Living Scale
to evaluate the elderly’s
ability to perform the more complex activities that are necessary for optimal
independent functioning.
UCLA Loneliness Scale by Russel Peplau and Ferguson developed in 1978,
consisted of 20 statements that reflected
how
lonely individuals .
MOS Social support inventory: Medical Outcomes Study (MOS), Social
Support Measurement developed by Cathy Donald Sherbourne and Anita L.
Stewart in 1991 has focused on the structure of interpersonal relationships.
The Perceived Stress Scale developed by Cohen, Kamarck and Mermelstein
in 1983. The Perceived Stress Scale (PSS) is the most widely used
psychological instrument for measuring the perception of stress.
Geriatric Anxiety Inventory (GAI) is a 20 items self-report measure of
anxiety. Gerard J. Byrne1 and Nancy A. Pachana (2007) created a reliable,
valid and easy to use instrument for anxiety that is specifically targeted at older
adults.
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It was discovered more than half of the sample size of the
respondents that is 183 were female respondents and 117
were male respondents. 110 (36.7%), having 69 (37.7%)
females and 41 (35.0%) males are between the ages 70–79
which shows a larger faction of the sample population is
aged.
Majority of the respondents for the study are Christians
comprising of 276 (92.0%) of the total respondents having
175 (95.6%) females and 101 (86.3%) male respondents
and the remaining part of the respondents are Hindus
having only 24 (8.0%) with 8 (4.4%) females and 16
(13.7%) male respondents constituted less than one-tenth of
the respondents. There are no residents belonging to
Muslim and SC/ST.
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The analysis on marital status of respondents indicated
that majority of the elderly are widowed that is 203
(67.7%) of the total population with 129 (70.4%)
female and 74 (63.2%) male respondents. 72 (24.0%)
of the respondents comprising of 43 (23.4%) female
and 29(24.8%) male respondents are those who had
never married.
It is evident that 86 (28.7%) of the sample elderly
respondents having 57 (31.1%) females and 29 (24.8%)
males are illiterate.
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The analysis on the elderly shows that majority of the
respondents that is 226 (75.3%) comprising of 119
(65.0%) females and 107 (91.4%) males do not have
any income and are dependent on charity or some other
financial assistance.
Majority of the respondents 130 comprising of 71.0%
female and 97 male comprising of 82.9% respondents
are living in the institution for 1 to 10 years. Nearly 44
of the total respondents, 32 (17.5%) female and 12
(10.3%) male respondents are living in the institution
for 11 to 20 years.
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Majority of the respondents 150 (82.0%) female and 112
(95.7%) are happy with the persons who take care of them
in the institution.
Majority of the respondents 148 (80.9%) female and 113
(96.6%) male feel that the caretakers in the institution show
love and respect towards them.
The data revealed in the study that a good number of
respondents 148 (80.9%) female and 112 (95.7%) male
respondents feel secure in the institution.
The study also reveals that 145 (79.2%) female and 112
(95.7%) male respondents feel belonging in the institution.
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A large majority, 263 (87.7%) were fully satisfied
with the conditions in the Institution. Only 37
(12.3%) were not satisfied but they stay back in the
institution as they have no other option of going back
to their family.
The data on preference of stay shows 162 (88.5% )
female and 101 (86.3%) prefer to stay in the institution
having all the benefits like spiritual, emotional, medical
and psychological support in the institution though they
have some feelings that they are away from the family.

Majority 117 (63.9%) female and 82 (70.1%) male felt
happy for being institutionalized. One reason of being
happy for having been institutionalized was that they
had no one to take care in the family as their children
had migrated and settled down in far off places. Some
of them were happy as they found security and safety in
the institutions since there are many cases of elderly
being abused or murdered in their own apartments or
houses.
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Institutionalization affects person as a whole – physical,
psychological, emotional social and spiritual. Health status
of the institutionalized elderly was assessed.
Hypertension is the main disease most of the elderly suffer.
Sixty six (36. 1%) female and 37 (31.6%) male respondents
had hypertension before coming to the institution and 33
(18.0%) female and 11(9.4%) male respondents developed
hypertension after coming to the institution.
The second main disease is Diabetes Miletus. Forty two
(23.0%) female and 26 (22.2%) male respondents were
suffering from diabetes Miletus before coming to the
institution.
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The appetite of the elderly before entering into the
institution and after entering into the institution was
assessed.
The researcher finds that majority that is 180 (98.4%)
and 115 (98.3%) had good appetite.
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To assess the emotional and psychological health, various
scales such as Anxiety Scale, Loneliness Scale, Perceived
Stress Scale and questions of the Interview Schedule 58, 59,
60, 61, 64, 65, 66 and 67 are being used.
Over all anxiety scale shows the female level of anxiety is
34.60 and the male level of anxiety is 30.33. The total level
of anxiety mean value is 32.94. Test shows that the level of
anxiety among the respondents is at moderate extent as the
Mean score is 32.94. Percentage of Mean score in female is
54.06% and male 47.40% and the total mean percentage is
51.46%.
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Loneliness is a major issue relating to quality of life and
well being of the older adult. Loneliness scale is a 20 item
questionnaire and each question is assessed on 4 point
rating scale as Never, Rarely, Sometimes and Always. Over
all Loneliness scale shows the female level of loneliness is
47.09 and the male level of loneliness is 48.34. The total
level of loneliness mean value is 47.58. Test shows that the
level of loneliness scale among the respondents is at high
extent as the Mean score is 47.58. Percentage of Mean
score is female 58.90% and male 60.40% and the total
mean percentage is 59.50%.
The majority of the respondents, 138 (75.4%) female and
83(70.9%) male are having loneliness at a high extent.
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The level of perceived stress scale among the respondents is
significant as the total percentage of mean score for female
is 32.78% and for male it is 35.93% and the total mean
percentage is 34.01. The test proves that 126 (68.9%)
female and 98 (83.8%) male respondents are having stress
at a moderate level, 51 (27.9%) female and 12 (10.3%)
male respondents are having lots of stress and the rest 6
(3.3%) female and 7 (6.0%) male are not stressed out at all.
Major findings of this study is that, overall social support,
daily activity and physical self maintenance will result in
coping with the stress and ill health.

The study is a descriptive design that investigated the life of
the elderly in the institutions, the impact of
institutionalization on the elderly, the anxiety, stress and
loneliness attached to that, with a theoretical framework of
Activity Daily Living and type of informal social support.
Face-to-face interview survey method using a structured
questionnaire was adopted for this study. Demographic data
was collected from all participants who met the inclusion
criteria. The data included age, gender, time of
administering questionnaires, institution where the elderly
lived, and length of stay in the home.

All the respondents were interviewed by the researcher
and were asked the questions, to be answered. The tests
were administered in the same order to make it
consistent, and the time of the day when the tests were
given was noted. Each interview lasted about 30-45
minutes depending on the level of functioning of the
participants. Observation method also was used to get
the desired report.
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The Statistical Package for Social Sciences (version
13.0) (SPSS) was used for the analysis and modeling of
the data.
Uni-variate analysis began with a descriptive analysis
of demographic, independent, and dependent variables.
Mean, median and standard deviation were utilized for
continuous variables, while frequencies and
percentages were applied to categorical variables.

Based on the information got through interviews,
observation and the analysis got from the different
scales used, the relationship between different variables
studied the life of the elderly in the institution and the
impact on physical, social, emotional and psychological
health has been assembled together.
Thank
you