THE LIFE STYLE OF THE ELDERLY AND IT'S IMPACT ON THIE QUALITY OF LIFE AT BARANGAY DAL-LIPAOEN...

8/7/2019 THE LIFE STYLE OF THE ELDERLY AND IT'S IMPACT ON THIE QUALITY OF LIFE AT BARANGAY DAL-LIPAOEN NAGUILIAN ,

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THE LIFE STYLE OFTHE ELDERLY AND ITS

IMPACT ON THEIR QUALITY OFLIFE AT BARANGAY DAL-LIPAOEN NAGUILIAN,LA UNION

An Undergraduate ThesisPresented to

the Faculty of the College of NursingUNION CHRISTIAN COLLEGE

In Partial Fulfillment of theRequirements for the Subject

Research I

By:

Avelino C. Marzo Jr.Nika Joyce NardoJoana Marie Casaclang

Ruzzell NimesMary Ann Generao

March 2011


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ACKNOWLEDGEMENTS

The researchers convey their deepest gratitude to the following thathave significantly contributed to this piece of work.

To Almighty God , for giving those unending blessing and wisdom,through Him, for without Him, none will be possible;

To their Introduction to Research Instructor, Mrs. Cadam-us , forsharing her precious time and knowledge and for her unending supportand encouraging words. It is through her that this meaningful projectwas conceptualized.

To their families, friends, and classmates, for their inspiringwords and encouragements during those times of sleepless nights of finishing this research proposal.

To all of you,

THANK YOU VERY MUCH!

The Researchers


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DEDICATION

With love and sincerity, this humble piece of work is heartily

dedicated to the people whose contribution is significant in making this

study a reality.

To our mentors , for the great effort they have exerted in molding

us to become well rounded and competent students of this institution.

To our families, friends and fellow students, for their

cooperation for the completion of this work and for their moral support

which inspired us in making things possible and in pursuing our

ambition.

Above all, to Almighty God who continually showers His infinite

wisdom, blessings, and skills to the researchers.

Avelino

Nika Joyce

Joana Marie

Ruzzell

Mary Ann


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TABLE OF CONTENTS

PageTITLE PAGE ....i

ACKNOWLEDGEMENT ......ii

TABLE OF CONTENTS .....iii

CHAPTER

1 THE PROBLEM

Background of the Study...1

Statement of the study ..................5

Theoretical framework. ..6

Research paradigm.............11

Hypothesis.12

Significance of the study.... 13

Scope and Delimitation....13

Definition of terms..13

2 REVIEW LITERATURE

The Dynamics of Population Ageing.15

Social and Cultural Changes..18

Legal Framework and Policy Responses 21

Program Intended to Offer Health Insurance to the Poor.24

Age distribution..27


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3 RESEARCH METHODOLOGY

Research Design..30

Population and

Sampling.30

Data Gathering Procedure31

Research Instrument..31

Data Analysis Plan..32


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CHAPTER 1

INTRODUCTION

BACKROUND OF THE STUDY

Lifestyle comes from two words life and style.

What is life? Life is a state that distinguishes organisms from non-

living objects, such as non-life, and dead organisms. Living organisms

are capable of growth and reproduction, some can communicate and

many can adapt to their environment through changes originating

internally. A physical characteristic of life is that it feeds on negative

entropy. In more detail, according to physicists such as John Bernal,

Erwin Schrdinger, Eugene Wigner, and John Avery, life is a member of

the class of phenomena which are open or continuous systems able to

decrease their internal entropy at the expense of substances or free

energy taken in from the environment and subsequently rejected in a

degraded form.

On the other hand, style has different meanings. First, style is the

way in which something is said, done, expressed, or performed: a style of

speech and writing. It is also defined as the combination of distinctive

features of literary or artistic expression, execution, or performance

characterizing a particular person, group, school, or era. Sort or type: a

style of furniture. A quality of imagination and individuality expressed in


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one's actions and tastes: does things with style. A comfortable and

elegant mode of existence: living in style. A mode of living: the style of the

very rich. It is a fashion of the moment, especially of dress; vogue. A

particular fashion: the style of the 1920s. It is a customary manner of

presenting printed material, including usage, punctuation, spelling,

typography, and arrangement.

The focus of this study is the elderly. Elderly or Old age consists of

ages nearing or surpassing the average life span of human beings, and

thus the end of the human life cycle. Euphemisms and terms for old

people include seniors chiefly an American usage or elderly. As

occurs with almost any definable group of humanity, some people will

hold a prejudice against others in this case, against old people. This is

one form of ageism. Old people have limited regenerative abilities and are

more prone to disease, syndromes, and sickness. The boundary between

middle age and old age cannot be defined exactly because it does not

have the same meaning in all societies than other adults. People in the

65-and-over age group are often called senior citizens. But the fact is

elderly should see to it that they should take care themselves by doing

the right health practices especially in their lifestyle. In sociology, a

lifestyle is the way a person lives. A lifestyle is a characteristic bundle of

behaviors that makes sense to both others and oneself in a given time

and place, including social relations, consumption, entertainment, and

dress. The behaviors and practices within lifestyles are a mixture of


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habits, conventional ways of doing things, and reasoned actions. A

lifestyle typically also reflects an individual's attitudes, values or

worldview . Therefore, a lifestyle is a means of forging a sense of self and

to create cultural symbols that resonate with personal identity.

Surrounding social and technical systems can constrain the lifestyle

choices available to the individual and the symbols she/he is able to

project to others and the self.

Many elderly and even young ones are very convenient in buying

over the counter drugs without knowing its right dose and effect. Health

regimen is a treatment plan. The plan includes which treatments and

procedures will be done, medications and their dose, the schedule of

treatments, and how long the treatment will take. Examples of health

regimen are exercise, diet, supplements and nutrition. Medication also

referred to as medicine, can be loosely defined as any substance intended

for use in the diagnosis, cure, mitigation, treatment, or prevention of

disease. Other synonyms include pharmacotherapy,

pharmacotherapeutics, and drug treatment.

One way also to monitor the health status of the elderly is in their

nutrition. The foods they eat and also the foods that they should avoid.

Nutrition is the provision, to cells and organisms, of the materials

necessary (in the form of food) to support life. Many common health

problems can be prevented or alleviated with good nutrition. The diet of


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an organism refers to what it eats. A diet is a pattern of food

consumption which is followed by a population or an individual. The

diets of populations are affected by local factors including geography,

climate, food availability, culture, and religion, whereas the diets of

individuals within populations are further influenced by factors such as

socio-economic status, personal preference, and health considerations.

To maintain life, all diets must supply the essential amounts of energy,

protein, essential fatty acids, vitamins, and minerals, but these needs

can be met by a wide variety of diets, each of which will be sufficient for

growth, survival, and reproduction but may also have obvious or subtle

effects on the long-term state of health. The idea of a healthful diet is to

provide all of the calories and nutrients needed by the body for optimal

performance, at the same time ensuring that neither nutritional

deficiencies nor excesses occur.

Promotion and preservation of health, also called hygienic.

Physical exercise is any bodily activity that enhances or maintains

physical fitness and overall health. It is performed for many different

reasons. These include: strengthening muscles and the cardiovascular

system, honing athletic skills, and weight loss or maintenance. Frequent

and regular physical exercise boosts the immune system, and helps

prevent diseases of affluence such as heart disease, cardiovascular


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disease, Type 2 diabetes and obesity. It also improves mental health and

Sanitation is the hygienic means of preventing human contact from the

hazards of wastes to promote health. Hazards can be physical,

microbiological, biological or chemical agents of disease. Wastes that can

cause health problems are human and animal feces, solid wastes,

domestic wastewater (sewage, sullage, greywater), industrial wastes, and

agricultural wastes. Hygienic means of prevention can be by using

engineering solutions (e.g. sewerage and wastewater treatment), simple

technologies (e.g. latrines, septic tanks), or even by personal hygiene

practices (e.g. simple hand washing with soap). Hygiene refers to

practices associated with ensuring good health and cleanliness. Such

practices vary widely and what is considered acceptable in one culture

may be unacceptable in another. In medical contexts, the term "hygiene"

refers to the maintenance of health and healthy living. The term appears

in phrases such as personal hygiene, domestic hygiene, dental hygiene,

and occupational hygiene and is frequently used in connection with

public health. Hygiene is also a science that deals with the helps prevent

depression. It is safe for most adults older than 65 years to exercise.

Many of these conditions are improved with exercise.

Leisure or free time is a period of time spent out of work and

essential domestic activity. It is also the period of recreational and

discretionary time before or after compulsory activities such as eating

and sleeping, going to work or running a business, attending school and


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doing homework, household chores, and day-to-day stress. The

distinction between leisure and compulsory activities is loosely applied,

i.e. people sometimes do work-oriented tasks for pleasure as well as for

long-term utility.

Nowadays many elderly are not that conscious about their health

especially when one elder is in financial crisis. Their priority is not on

their health but on their foods. Because of the new trends and new

developments nowadays elderly is the last one who can adapt to these

changes. Thats why this study was made to know if these changes or

new lifestyle affects the old practices and lifestyle of the elderly and if

these new changes have an impact to their quality of life. On the other

hand the family members of elderly are also subjected to this study. They

are playing a big role in taking good care and watching the elderly in

their homes. Sometimes the family members are the one reminding the

elderly what to do and what not to do because in this stage of their life

they forget almost all the things including the simple things and even

they forget to take care their own selves.

STATEMENT OF THE PROBLEM

The researchers would like to assess the lifestyle of the elderly and

its impact to their quality of life at Barangay Dal-lipaoen Naguilian, La

Union which intends to answer the following problems:

1. What is the lifestyle of the elderly as perceived by the respondents


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along with the following areas?

a. Health regimen and Medication

b. Diet and Nutrition

c. Hygiene and Sanitation

d. Exercise or Leisure

2. What are the significant differences in the responses of the

respondents as to the lifestyle of the elderly?

3. What is the perception of the respondents as to the extent of influence

of the lifestyle of the elderly to their health status along with the

following areas?

a. Health regimen and Medication

b. Diet and Nutrition

c. Hygiene and Sanitation

d. Exercise or Leisure

4. What are the significant differences in the perception of the

respondents as to the extent of influence of the lifestyle of the elderly to

their health status?

THEORITICAL FRAMEWORK

Health Belief Model (Rosenstock, Becker, Kirscht, et al.)

This model was originally introduced by a group of psychologists in

the 1950's to help explain why people would or would not use available

preventive services, such as chest x-rays for tuberculosis screening and


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immunizations for influenza. These researchers assumed that people

feared diseases and that the health actions of people were motivated by

the degree of fear (perceived threat) and the expected fear reduction of

actions, as long as that possible reduction outweighed practical and

psychological barriers to taking action (net benefits).

The HBM can be outlined using four constructs which represent

the perceived threat and net benefits: 1) perceived susceptibility, a

person's opinion of the chances of getting a certain condition; 2)

perceived severity, a person's opinion of how serious this condition is; 3)

perceived benefits, a person's opinion of the effectiveness of some advised

action to reduce the risk or seriousness of the impact; and 4) perceived

barriers, a person's opinion of the concrete and psychological costs of

this advised action. Another concept is known as cues to action. These

are events (internal or external) which can activate a person's "readiness

to act" and stimulate an observable behavior. Some examples of external

strategies to activate "readiness" can be delivered in print with

educational materials, through any electronic mass media or in one-to-

one counseling. Another concept that has been added to HBM since 1988

in order to better meet the challenges of changing unhealthy habitual

behaviors (such as being sedentary, smoking or overeating) is self-

efficacy. Self-efficacy, a concept originally developed by Albert Bandura in

social cognitive theory (social learning theory), is simply a person's

confidence in her/his ability to successfully perform an action.


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The HBM has been used to help in developing messages that are

likely to persuade an individual to make a healthy decision. Using the

HBM, messages that are suitable to health education for such topics as

hypertension, eating disorders, contraceptive use, or breast self-

examination have been developed.

However, there are two main weaknesses which have been noted

about the HBM. First, health beliefs compete with an individual's other

beliefs and attitudes which can also influence behavior. Secondly, in

decades of research in the social psychology of behavioral change, it has

not been shown that belief formation always precedes behavioral change.

In fact, the formation of a belief may actually follow a behavior change.

Theory of Reasoned Action (Fishbein and Ajzen)

The Theory of Reasoned Action was designed to explain not just

health behavior but all volitional behaviors. This theory is based on the

assumption that most behaviors of social relevance are under volitional

(willful) control. In addition, a person's intention to perform (or not

perform) the behavior is the immediate determinant of that behavior. The

goal is to not only predict human behavior but also to understand it.

According to this theory, a person's intention to perform a

specific behavior is a function of two factors: 1) attitude (positive or

negative) toward the behavior and 2) the influence of the social


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environment (general subjective norms) on the behavior. The attitude

toward the behavior is determined by the person's belief that a given

outcome will occur if he/ she performs the behavior and by an evaluation

of the outcome. The social or subjective norm is determined by a person's

normative belief about what important or "significant" others think he/

she should do and by the individual's motivation to comply with those

other people's wishes or desires.

Attitudes are a function of beliefs in this theory. If a person

believes that performing a given behavior will lead to on the whole

positive outcomes, then he/ she will hold a favorable attitude toward

performing that behavior. On the other hand, a person who believes that

performing the behavior will lead to mostly negative outcomes will hold

an unfavorable attitude. These beliefs that form the foundation of a

person's attitude toward the behavior are referred to as behavioral

beliefs.

Subjective norms are also a function of beliefs. However, these

are beliefs of a different kind. These are the person's beliefs that certain

individuals or groups think he/she should or should not perform the

behavior. If the person believes that most of these significant others

think he/she should perform the behavior, the social pressure to perform

it will increase the more he/ she is motivated to comply with these

others. If he/ she believe that most of this reference group is opposed to


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performing the behavior, her/his perception of the social pressure not to

perform the behavior will increase along with her/his motivation to

comply with these referents. The beliefs which underlie a person's

subjective norms are termed normative beliefs.

Social Networks/Social Support Theories (Eng, Israel, et al.)

Most health educators today recognize the critical importance of

the social environment and advocate changes in the social ecology which

is supportive of individual change leading to better health and a higher

quality of life. However, within the community, long-term behavior

change depends on the level of participation and ownership felt by those

being served. In order to see how Social Networks and Social Support

Theories might impact on health needs, it is first necessary to define

what is meant by certain concepts.

Social networks can be kin (extended family) or non-kin (church

or work groups, friends or neighbors who regularly socialize clubs and

sporting teams). Social networks have certain types of characteristics: 1)

Structural, such as size (number of people) and density (extent to which

members really know one another); 2) Interactional, which include

reciprocity (mutual sharing), durability (length of time in relationship),

intensity (frequency of interactions between members), and dispersion

(ease with which members can contact each other); and 3) Functional,

such as providing social support, connections to social contacts and


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resources, and maintenance of social identity.

Social support refers to the varying types of aid that are given to

members of a social network. Research indicates that there are fourkinds of supportive behaviors or acts: 1) Emotional support - listening,

showing trust and concern; 2) Instrumental support - offering real aid in

the form of labor, money, time; 3) Informational support - providing

advice, suggestions, directives, referrals; and 4) Appraisal support -

affirming each other and giving feedback. This social support is given

and received through the individual's social network. However, it is

important to remember that "some or all network ties may or may not be

supportive."


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HYPOTHESIS

The elderly are prone to illnesses because of the deterioration of

health especially physically and mentally. And one factor that affects theelderly is the lifestyle. Their attitude toward their health regimen and

medication, diet and nutrition, hygiene and sanitation, leisure and

exercise and other practices of the elderly affect their quality of life:

Physically, Socially, Emotionally and Mentally.

SIGNIFICANCE OF THE STUDY

The researchers keep on seeking for answers so that they can help

in their simple ways in their society. People are not getting any younger.

And as they struggle towards their end, our elders sometimes neglect

their own necessities. In a way they do things which they dont usually

do before.

This research is made so that the elders would know that even

though they are already old, they still have to take good care of

themselves. Not just to look neat in the crowd but also to prolong their

life.

As long as we live in this world we are obliged to have a quality way

of living. Our life is a gift from above, so we mustnt do things that could

harm ourselves. Live life and love till our end comes.


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SCOPE AND DELIMITATION

This research is wide and the research is not a computer to give

you all the knowledge about suicide. The researcher did not include:

1.

The Impact of treated hearing loss on quality of life.

2.

Impact on quality of life of fecal incontinence on older adults.

3.

Depressed elderly have worst quality of life.

DEFINITION OF TERMS

1.

Life- A state that distinguishes organisms from non-living

objects, such as non-life, and dead organisms

2.

Lifestyle- the habits, attitudes, tastes, moral standards,

economic level, etc., that together constitutes the mode of living

of an individual or group.

3.

Elderly- pertaining to person in later life

4.

Humanity- the quality or condition of being a human


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INDEPENDENT DEPENDENT VARIABLES VARIABLES

Lifestyle of the elders: Quality of Life

a.

Health regimen and

Medication

b.

diet and Nutrition

c. hygiene and Sanitation

d.

leisure and Exercise

Figure 1: Research Paradigm


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CHAPTER II

REVIEW OF LITERATURE

THE DYNAMICS OF POPULATION AGEING

From 3.19 million in1990, the senior citizens in the Philippines

increased to 4.59 million in 2000. The decadal average annual

(exponential) growth rate of 3.64 percent of the population 60 years and

over went up from the 2.26 percent growth rate recorded during the

previous decade. Hence, the older population is growing faster than the

total population of the Philippines. If the countrys total population is

already rapidly growing, then the myth that population ageing in the

Philippines is low and slow is not true and therefore doubling time is

shorter for the older population than for the total population. The

medium series of the population projection indicates that senior citizens

with be 10 percent of the Philippine population by 2030, with the female

population attaining such proportion five years earlier than the male

population. The projected sex ratio of the population 60 years or higher

would continue to be lower than 100, with female dominance increasing

by age.

However, population ageing is also happening in various

geopolitical areas of the country. Figure 7 reveals that the National

Capital Region (NCR) and the Ilocos Region will have 10 percent of their

population in the 60 years and over category by 2020. Regional data also


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revealed that the female population would reach such proportion earlier

than the males. The female senior citizen population of Ilocos Region

would reach ten percent by 2015 in contrast to 2025 for its male

population.

The population ageing process varies not only by sex and region

but also by province. Moreover, the year when a province starts to have

at least 10 percent belonging to the 60 and over age group may not be

immediately be mirrored at the regional level. Five provinces already

counted in the 2000 census at least 10 percent of their population in this

age category (see Appendix B). These provinces are Ilocos Sur and Ilocos

Norte of Region I Ilocos Region, Batanes of REGION II - Cagayan Valley,

Siquijor of REGION VII - Central Visayas, and Southern Leyte of REGION

VIII - Eastern Visayas. Moreover, the regions where they belong to would

attain the 10 percent regional population mark by 2020, 2025, 2025,

and 2035, respectively. This suggests that while local government units

(LGUs) in smaller geopolitical units such as provinces, cities, and

municipalities would have to be more receptive of the demographic

changes occurring in their localities inasmuch as the national and

regional population ageing could occur much later. This explains why the

national and regional governments could initially be impervious to

demographic shifts and their attendant consequences. Hence provinces,

cities and municipalities should be more in tune with and responsive to

changes in their own demographic processes and outcomes.


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Another aspect of the population ageing process is the changing

balance between age groups. Over the last half of the twentieth century,

the proportion of children (0-14 years old) in the world dropped from 34

per cent in 1950 to 30 percent in 2000. But the proportions of aged

persons increased so that by 2050 the UN (2001) projected that the share

of persons aged 60 or over in the population will match that of persons

younger than 15 (about 21 per cent each). The Philippines has likewise

experienced such a shift in age structure. From 45.7 percent in 1970, the

proportion of the population less than 15 was down to 37 percent in

2000, an 8.6 percentage point decline over a 30-year period. However,

the 2000-based official population projection of the Philippines (medium

series) reveals a larger percentage increment in the 60 years and over

(7.9 percent) than in the economically productive ages (5.7 percent) by

end of the projection period (2040). The larger percentage increase of

senior citizens would come from the 70-79 years and the 80 years and

over age groups. These expected shifts in the age composition of the

Philippines would signal a change in the pattern of resource distribution

in aid of averting intergenerational conflicts (Walker 1990 and Jackson

1998 as cited in UN 2001) since demographic ageing could lead to calls

for greater attention to the needs of the growing number of older persons.

The ageing index, which is calculated as the ratio of those 60 years

or older to those less than 15 years old, provides a commonly used

measure for assessing this process. The ageing index of the Philippines


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increased from 10 senior citizens per hundred children less than 15

years old in 1970 to 16 per hundred in 2000. The medium series of the

Philippine population projection indicates a nearly fourfold increase of

the ageing index by the end of the projection period. This means that by

2040, there will be almost two persons aged 60 or over for every three

children under 15 years in the Philippines. Hence, there may be a need

to reassess the long-term care options for the growing population of older

persons, and the optimal resource distribution in view of the shift in the

young-old balance of the countrys population.

Since support at older ages is a common motive for sustained high

fertility in developing countries, often used to measure the potential

elderly support requirements in a society is the old-age dependency ratio.

The working age population is assumed to provide either direct or

indirect support to the youth and the elderly through the family, religious

or communal institutions, or even the State. Hence, the dependency ratio

is a rough estimate of the burden of dependency and is useful indicator

of trends in the level of potential support needs.

The total dependency ratio in the Philippines would decline as

children below age 15 decreases and senior citizens increases. There will

also be a profound shift in the composition of the total dependency ratio:

the share of the old-age component would rise from 9 percent to 29

percent from 2000 to 2040 (see Figure 10), which is almost triple within

the next 40 years.


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An alternative way of expressing the numerical relationship

between those more likely to be economically productive and those more

likely to be dependents is the potential support ratio (PSR). PSR is the

inverse of the old-age dependency ratio, that is, the number of people in

the working ages of 15-64 years per person 65 or older. Figure 10 shows

that in the Philippines the PSR of 15 in 2000 would drop to seven by

2040. This means there were 15 persons in working-ages who provided

support to one senior citizen in 2000.

In 2040, there would be seven persons in working ages that will

support one older person. This is a 55 percent reduction in the potential

support ratio over the next 40 years. There is larger regional variability in

PSR in 2000 than the expected scenario in 2040. Despite the regional

variation in the initial and final PSR, the general pattern is a reduction of

PSR in all regions between 2000 and 2004 (Table 1). The top three

regions with the largest percentage reduction in PSR over the next 40

years are NCR, ARMM, CALABARZON, and Davao.

PSR also varies by province as shown in Appendix C. Again,

provincial population ageing alert signals are not reflected immediately in

regional population scenarios. Hence, LGUs that monitor closely their

respective demographic indicators would be better able to design local

policy responses and initiatives to address population ageing.


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SOCIAL AND CULTURAL CHANGES

In a developing country like the Philippines, the quality of life of

older persons depends largely on the family support system. The family

and the home are pivotal points of exchange of support and care among

older and younger generations. Is there a change in the role of older

persons within the family? Earlier studies have shown that there is little

evidence of change in the social position of the elderly as they age in

terms of standard of living, familial interaction and support, or health

services (Casterline et al. 1991). Based on focus group discussion data,

however, Williams and Domingo (1992) have found that being better off

in terms of health, frequency of social contacts and financial

independence enables older persons to have more influence in family

decisions. Recent research updates on these would be helpful in

documenting shifts in elderly role in Filipino family dynamics, especially

in family decision-making.

The Filipino family as the building block of the nation appears

resilient despite transformative forces in its own core. Children continue

to symbolize love and joy that keep families together but marriage (i.e.,

the social institution that brings families into being) seems to be in a

flux. Data suggest that traditional norms of early and universal marriage

are eroding. Males and females in the Philippines are delaying their entry

into marriage. The singulate mean age at marriage (SMAM) or the

number of years spent at single hood has increased from 25 years for


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males and 22 for females in 1960 (Gultiano and Xenos 1992) to 26 years

for males and 24 years for females in 2000 (Williams , Kabamalan and

Ogena 2001). On the other hand, the males are catching up with the

females in not marrying as the gender gap in the proportion who never

married at age 4549 years declined over the same time period. The

proportion for males has nearly doubled (i.e., from 3.2 percent in 1960 to

5.6 percent in 2000), while for females the proportion slightly declined

from 7.1 percent in 1960 to 6.1 percent in 2000. Cohabiting unions

among young Filipinos also increased between 1994 and 2002 with

frequent media portrayals of cohabiting couples challenging the more

conservative positions against the practice (Kabamalan 2004). If these

changes in nuptiality in the Philippines continue in the next decades and

be large enough, Costello and Casterline (2002) suspect a downward

pressure on Philippine fertility as what happened in many parts of the

world. In turn, this could further speed up the population ageing process

as mortality level has flattened at a quite low level due to improvements

in health care and hygiene.

Marital instability and spousal separation also strike at the

foundations of the Filipino family. There is no divorce law in the

Philippines so marriage when formalized binds a man and woman for life.

Many married couples, especially those with children, remain together

despite marital troubles for the sake of the family. As expected therefore

is the rather low level of marital dissolution in the country although a


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slight increase was noted during the 1990s (Costello and Casterline

2002). Despite lack of a divorce option, a married couple who wish to

break away legally from a marital partner may choose annulment of

marriage, which of course has corresponding social, temporal, and

financial costs. Nevertheless, this option has become quite popular

recently not just for the upper but also for middle classes. Again, media

appears to play a large part in having this included as an option in the

lifestyle change of married couples in the country along with changes in

peoples attitudes and behavior regarding marriage and family formation.

Perhaps more of a challenge to marital stability is the temporary

spousal separation due to overseas work of a marital partner. As of

December 2004, there were 8.08 million Filipinos overseas, with nearly

half (44.52 percent) on temporary work contract abroad. The average

annual deployment of OFWs during the period 2000-2005 was 897

thousand (POEA 2006). OFW remittances increased from US$6.03 billion

in 2001 to US$10.69 in 2005 (BSP 2006). Documented economic gains

from these remittances abroad have benefited many families and the

country as a whole but providing mechanisms to channel remittances to

productive investments is a continuing challenge.

LEGAL FRAMEWORK AND POLICY RESPONSES

In recognition of the family as the basic unit of society, the

Constitution of the Republic of the Philippines recognizes the families


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duty to take care of elderly members but the State may also do so

through just programs of social security (RP 1987). The needs of older

persons, among others, are included in the priority list when designing

and implementing integrated and comprehensive programs that would

make essential goods, health, and other social services available to all

the people at affordable cost.

The Philippine Constitution and three enacted laws since 1992

recognize the positive role of older persons in society. The objectives of

the first piece of legislation for older persons in the Philippines, i.e.,

Republic Act (RA) No. 7432, are to motivate and encourage the senior

citizens to contribute to nation building and to encourage their families

and communities they live with to reaffirm the valued Filipino tradition of

caring for their senior citizens. This law granted the following privileges

to senior citizens (RA

7432, Section IV):

a) The grant of twenty percent (20 percent) discount from all

establishments relative to utilization of transportation services, hotels

and similar lodging establishment, restaurants and recreation centers

and purchase of medicines anywhere in the country: Provided, That

private establishments may claim the cost as tax credit;

b) A minimum of twenty percent (20 percent) discount on admission fees

charged by theaters, cinema houses and concert halls, circuses,

carnivals and other similar places of culture, leisure, and amusements;


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c) Exemption from the payment of individual income taxes: Provided,

That their annual taxable income does not exceed the poverty level as

determined by the National Economic and Development Authority

(NEDA) for that year;

d) Exemption from training fees for socioeconomic programs undertaken

by the OSCA as part of its work;

e) Free medical and dental services in government establishment

anywhere in the country, subject to guidelines to be issued by the

Department of Health, the Government Service Insurance System and

the Social Security System;

f) To the extent practicable and feasible, the continuance of the same

benefits and privileges given by the Government Service Insurance

System (GSIS), Social Security System (SSS) and PAG-IBIG, as the case

may be, as are enjoyed by those in actual service.

In 1995, passed was RA 7876 or the "Senior Citizens Center Act of

the Philippines" which established senior citizens centers in every city

and municipality of country. The centers serve as venues for the delivery

of integrated and comprehensive services to older persons. The

organizations of older persons manage these centers with the support of

the local and national governments.

Based on the Vienna Plan of Action on Ageing and the Macao Plan

of Action on Ageing for Asia and the Pacific, the Philippines adopted the

Philippine Plan of Action for Older Persons in 1999. The plan of action


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addresses eight major areas of concern: namely, older persons and the

family; social position of older persons; health and nutrition; housing,

transportation and environment; income security, maintenance, and

employment; social services and the community; continuing

education/learning; and, older persons and the market.

The most recent law passed (RA 9257) known as the "Expanded

Senior Citizens Act of 2003" grants additional benefits and privileges to

senior citizens without qualifying whether not they earn less than

P60,000, which was a prerequisite under the old law. The full

implementation of these laws, however, would benefit millions of senior

citizens but complains abound regarding rampant violation of seniors

discounts by operating establishments especially in rural areas.

Moreover, many of the older persons are neither aware of the existence of

the laws nor of the mechanisms to enable them to availing of such

benefits. But even if they are aware and knowledgeable of these

mechanisms, limitations in older peoples mobility could prevent them

from acquiring required documentation to prove that they are qualified

for the discounts and much more in availing themselves of the senior

citizen discounts due them. Again, the OFW phenomenon contributes in

preventing the trickle down effect of benefits to senior citizens especially

in the rural areas. With the absence of children and no surrogates who

could assist the older persons, the benefits from existing laws remain to

be fulfilled.


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Nevertheless, Philippine legislators continue to work on policy

reforms that would further improve the conditions of senior citizens in

the country. Pending bills in the House of Representatives and the

Senate include the following, among others: local governance

representation of senior citizens; increase the discount privileges enjoyed

by senior citizens to all establishments; lowering of retirement age of

teachers; protection from institutional, community and domestic violence

and sexual assault; and expansion of the discount benefit from just

prescribed medicines to cover all types of medicines Except for the

proposed lowering of retirement age of teachers, the other pending bills

may put less strain on government coffers. While 55 years may be

considered as appropriate for optional early retirement, the increasing

life expectancy of males and females and the growing number of older

people in the country suggest that the proportion of national resources to

be allocated to retirement benefits is expected to increase over time.

Hence, rather than reduce the age of retirement, prospects of increasing

it may be more economically rational, as what advanced European

countries with large elderly population are currently considering.

Another issue is whether retirement age should be legislated in view of

significant age-structural shifts anticipated in the next decades.


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A Program Intended to Offer Health Insurance to the Poor

A program sponsored by the International Labor Office and the

World Bank that is under way in the Philippines has offered hope for a

solution to an enduring problem of developing countries: providing

health insurance to poor people. The solution involves adding a

reinsurance backstop to small, regional insurance plans to guarantee

their solvency through periods of extreme need.

Private insurers rarely offer insurance to poor people, since their

health is usually worse than that of wealthier people and they cannot

afford to pay high premiums. So in developing countries, governments or

donors typically offer limited aid in the form of free care. That, however,

does not take advantage of the benefits of risk-pooling, and assumes that

the poor have no ability to share the cost of care. As a result, medical

care maybe severely underprovided.

Small regional insurance plans already address this problem in the

Philippines and elsewhere in the developing world. But these small plans

are extremely susceptible to insolvency when faced with an epidemic or

other health catastrophe that might befall an entire community. The

I.L.O. and the World Bank set out to demonstrate the positive impact of

the small plans and to demonstrate the practical potential for

reinsurance.

At a meeting in Montreal last week, the program's organizers

reported results from a survey of members and nonmembers of small


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insurance plans with various backers in five regions of the Philippines.

Hospital visits were 40 percent higher, on average, among members than

among comparable nonmembers in the last two years. Compliance with

drug regimens for the chronically ill was higher in all five regions

reported, reaching 100 percent among the survey's respondents in one

region, La Union. In four of the five regions, mortality rates for micro

insurance members were substantially lower in the last five years than

mortality rates compiled from regional statistics.

"Where governments and the private sector have failed to reach

low-income and low-health-status people the poor we have found

alternative solutions that make a big difference," said David M. Dror, a

health insurance specialist at the I.L.O. who is a co-director of the

program.

The results also suggested that reinsurance could work, at a

surprisingly small cost. Under reinsurance, the small insurance plans

would pay premiums to a central fund each year. If one of the small

plans is unable to cover its own losses in a given year, the central fund

would pay out an award the equivalent of a regular insurance claim

to bail out the plan. Within six years, according to a range of estimates

by the I.L.O., reinsurance could expand to encompass regional plans

covering 600,000 to one million people in the Philippines.

Starting the program would require an initial injection of capital in

case catastrophic losses occurred in the first few years, before the plans'


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reinsurance premiums had accumulated. Despite the increased medical

care among the plans' members, according to Dr. Dror's calculations, the

amount needed to keep the system solvent would be only about $9

million.

The Filipino program is the most extensive yet tried, said Elisabeth

Rhyne, senior vice president of Action International, a nonprofit

antipoverty group based in Boston that makes small loans to poor

entrepreneurs in Africa and the Americas. Previous micro insurance

efforts, she said, usually covered only "a very limited package of

services," not including in-patient hospital care. More ambitious

programs had a difficult time calibrating coverage to need, ensuring the

availability of medical care and achieving diverse pools of healthy and

sick people, Dr. Rhyne said, and thus could not even attempt

reinsurance.

Yet the money to start the reinsurance program has not been

forthcoming, either from the government, independent donors or private

insurance companies. The program's organizers have paid for training

and administration in the Philippines so far, but neither has a mandate

to provide the start-up funds.

"It's too small for the big money that usually finds takers for

infrastructure," Dr. Dror said. "On the other hand, there are still a lot of

people in the development community and the donor community that live

under the assumption that the poor are uninsurable."


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Dr. Dror and his colleagues came up with the figure of $9 million

in start-up funds by measuring health risks and the cost of care for the

populations already insured in the five regions about 40,000 people

and adding a conservative margin of error. Just less than 5 percent of

the population suffers from chronic disease, but more than half of

hospitalizations cost $50 or less. About half of the $9 million would pay

for administration, Dr. Dror said.

"If you don't come with some initial capital, no insurance can ever

work," Dr. Dror said. "You have to be capitalized at your maximum

exposure."

Covering widely dispersed micro insurance units under the same

reinsurance umbrella would be crucial to containing that exposure, said

Howard C. Kunreuther, a professor of decision sciences and public policy

at the University of Pennsylvania. When all the insured are concentrated

in one area, he said: "Whatever the risk is, there are always possibilities

of high correlation. That's what you try to avoid in insurance, if you can

are there any sicknesses that could really hurt everyone?"

Once reinsurance systems are up and running, though, micro

insurance units in villages all over the world could protect each other

from epidemics, with a slim chance that all would befall the same

catastrophe at the same time.

"You can pool the north of the Philippines with the south of the

Philippines, which is about as different as Cambodia is from Africa," Dr.


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Dror said. "Every village that joins this social reinsurance is assessed

according to their variance of risk, and thus you can pool any kinds of

risks."


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Chapter III

RESEARCH METHODOLOGY

RESEARCH DESIGN

This chapter presents the methods and procedures to be adopted

by the researchers. It includes the research design, the population and

locale of the study and sampling techniques, the method of data

collection, the instrument and the statistical technique employed for data

analysis.

In this study, the researchers used the descriptive method to

determine objectives that it seeks to attain. According to Bienvenido and

Medel, descriptive research involves the description, recording, analysis

and interpretation of the nature of composition and processes of

phenomenon.

Furthermore, descriptive survey method according to Best is

concerned with conditions that exist; practices that prevail; beliefs,

points of view or attitudes held; effects that are being felt; or trends that

are developing. However, it is not confined to fact gathering alone. It

involves an element of interpretation of meaning or significance of what

is described.

POPULATION AND SAMPLING

The respondents involved in the study were the elderly people of

Barangay Dal-lipaoen Naguilian, La Union. The age bracket is 60 years

old and above at present. The total population of the elders in this


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barangay is 100.

All of these elderly people were included as respondents. According

to Gay, as cited by Adanza, in descriptive research, ten percent of the

population is an acceptable sample but twenty percent of the total

population is required for a small population.

However, the researchers favored the idea that the bigger the

sample, the more valid are the findings and conclusions; Hence, we used

the total number of the population.

DATA GATHERING PROCEDURE

Following the approval and validation of the data gathering tool,

the researcher formally asked for the approval of the Barangay Captain

of Dal-lipaoen Naguilian, La Union in the administration of the

questionnaire to the elders in that Barangay. The questionnaires were

distributed by the researchers which were guided by the health workers

on where they could find the abodes of these elders. During the

distribution, the researchers explained the purpose of the research and

that their responses would be treated with confidentiality and respect.

The questionnaire was composed of many questions which made it

hard for the respondents to answer it in just one seating. The

questionnaires were distributed to the population and were retrieved

after 2 days by some members of the group.


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RESEARCH INSTRUMENT

The main data gathering toll used in collecting information was a

one set questionnaire constructed by the researchers. This questionnaire

contains question related to the awareness of the elder of their health

practices and how does it affect their quality of life. This questionnaire

was very lengthy and is composed of the questions formulated by the

researchers about their Health Regimen and Medication, Diet and

Nutrition, Hygiene and Sanitation, and Leisure and Exercise.

According to Sevilla, et al, validity refers to the appropriateness,

meaningfulness and usefulness of inferences a researcher on the data

collected. She added that a common way of determining the content

validity of an instrument is by having one or more individuals look at the

content and format of the instrument and judge whether or not they are

appropriate. Thus, validity of an instrument is established by the

judgment of three competent persons in the given field.

The first questionnaire was presented to the panel for review,

modification and validation. The panels gave 4.2 and 4 for the

questionnaire and for the final score is 4.1 which mean that the

formulated questionnaires are valid and the researchers were permitted

to float the questionnaire to the population.

DATA ANALYSIS PLAN

The data gathered has been tallied, tabulated, analyzed and

interpreted. The statistical tool used is the weighted mean. The mean


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describes the level of awareness or the perception of the elders of their

lifestyle and the following scale and descriptive equivalent was used for

its assessment and analysis.

On the other hand, the mean describes the perception of the elders

on the effects of their practices to their quality of life; physical, social,

mental, emotional. The following scale and descriptive equivalent was

used for the assessment and analysis.

THE LIFE STYLE OF THE ELDERLY AND IT'S IMPACT ON THIE QUALITY OF LIFE AT BARANGAY DAL-LIPAOEN...

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