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Although an appropriate institution was established
to provide care for the elderly in Kuwait, findings from a recent
study of the inmates of one of such institutions seemed to suggest
a need for a comprehensive assessment of the health and health-related
needs of the elderly. However, there have not been many studies on
assessment of the
needs of the elderly in Kuwait. The study mentioned earlier, focused
mainly on psycho-geriatric problems of 23 elderly male patients in
a geriatric home[8]. Results from this study emphasized the need for prevention and minimization of social
and mental problems in the old as well as physical problems. It also
emphasized the important role of the elderly family support to prevent
mental and psychological
deterioration. The objectives of the current study therefore, were
to study the factors influencing the independence in performance of
the activities of daily living (ADL) of the elderly population.
Patients and Method
This study adopted a Comprehensive Geriatric Assessment Method using
a modified version of a standardized international questionnaire similar
to M. Mead[ 6 ]. The first three sections of the questionnaire consisted
of collection of data regarding basic socio-demographic characteristics
of the elderly, their current medication and history of medical diseases.
Section four concentrates on extensive evaluation of physical, mental
and psychosocial domains[ 6,7 ], followed by assessment of self dependence
for A D L to identify those at risk, or who may need additional support
from nurses, social workers, physiotherapists and other helping
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agencies[ 6,7 ]. Many criteria were scored
based on
literature[ 6,7,9 ] such as the ADL. Basic ADL are those necessary
for individuals to care for themselves within a limited environment
e.g., getting dressed, eating alone, going to the toilet, combing
hair, bathing, using the telephone etc. Functional impairments were
identified mainly through interviewing the patient; evidence of cognitive
impairment in the patient necessitated that additional history is
collected from a collateral source of help (the care-givers). A score
of two points was given to the patient for each activity when the
patient could do it without help, one point when done with the help,
and no points when unable to do the activity; a total score of 16
as independent and zero for totally dependent[ 10,11 ]. For depression,
the Yesavage Geriatric Depression scaling method was adopted which
contained a 15-item questionnaire; with more than five points the
patient was labeled depressed[7,10, 11 ]. Assessment of the mental
function was based mainly on tests involving calculation and recall
of three items, which are more sensitive as a measure of cognitive
function than orientation tests[ 7,10,11 ]. The Folestin MMSE which
is Mini Mental State Examination used for grading cognitive status
was used for assessment when the patient showed inability to recall
three items. A single summary score was used to
 
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