EPIDEMIOLOGY OF SELF-DEPENDENCE AMONG KUWAITI ELDERLY POPULATION OF ABDULLAH AL-SALEM AREA

England in 1996 on elderly patients who were physically disabled and cognitively impaired showed that very elderly people and those with cognitive impairment make up a large proportion of those in need of long term care, institutionalized care or intensive home care[20]. Patients should be aware of the likely changes and the methods to cope with them, but there is little awareness of the importance of regular follow-up and preventive initiatives for the aged.

Although the majority of patients were living in nuclear families, 13 patients (11.5%) had less than adequate social support, some to the degree of being neglected. Four were living alone: two of them were neglected as one was single with no children and another one elderly lady was living with her son and his family, but she was neglected and left in an isolated room under the care of a servant who did not look after her well. This last case although probably not frequently seen in our country, reflected a serious example of elderly neglect and abuse, a tragic consequence of social disruption in families. 

A national study done in 1992 in Britain had shown that the prevalence of elderly abuse in the patient’s own home was significant with physical abuse 2% and verbal abuse 5%[20,22,23]. 45% of carers of the elderly in respite care admitted to some form of abuse in one study[20]. The problem of abuse had received little attention because physicians usually sense that raising the question of abuse, threatens the trust needed in the therapeutic relationship[24]. Neglect is one form of elderly abuse, which needs to be discussed with carers and involved care agencies, social services, or the police in case of evident 

crime. Admission to a safe place may have to be considered[20,25]. The Ministry of Health in Kuwait had been seriously directing the scope of care to the elderly in the country this year to avoid such tragic events. There had been intensive programs to construct protocols for the comprehensive care of the elderly in Kuwait in conjunction with the Ministry of Social Affairs and the Rehabilitation Hospital. The significant correlation noticed between receiving clinical care at home and having normal psychological state probably suggested that receiving regular follow-up and clinical care at home on the long run and not on demand only, would result in a better psychological state for the old. 

A study done on 100 elderly patients who were living in the community in Australia in the year 2000 suggested that the usefulness of regular preventive home visits was limited to those 75 years old and above[24] ,while other studies in 1999 did not favor home visits to elderly patients 65 years old, or younger[26-28].