The prevalence of disabilities among the elderly population. What is the range of disabilities and how to prevent it

1. Comparisons of
Disabilities Amongst Old People in
Home-Based Care and in
Home’s for the Elderly in Bahrain
Dr. Faisal Al-Nasir, FRCGP, MICGP, Ph.D
Dr. M. K. Al Haddad, FRC, Psych
Arabian Gulf University, Bahrain

2. Introduction
• The number of people over 65 years has increased globally
Al-Nasir F, Haddad M. 1993
• U.K. - 500,000 elderly people living in institutional careHer Majesty’s
Stationery Office, 1990.
• Rise in the number of older people with disabilities
• It is claimed that between the ages of 65-74 years:
 3% of the total population will have some cognitive impairment
Evans DA et al. , 1989
 by the age of 85 nearly half may be demented Percentage rises to 66%
when the elderly are institutionalized
Bland RC, Newman SC, Orn H. 1988

3. The Bahrain Goal and
Present Situation
• Two homes for the elderly are available in Bahrain
– The first, built in 1985, in Isa Town - capacity 48 beds
– The second -in Muharraq opened 1996 - capacity 60 beds
To maintain the wellbeing of the elderly,
but within their own home

4. Eligibility Conditions for Admission
to Old Peoples Homes in Bahrain
• To be eligible the elderly must be:
– Bahraini Nationals
– Free from infectious diseases or mental disorders
– Without visible means of support
– Prepared to live in the home
– Having families that are unable to provide
the necessary care

5. Methods and Subjects
• Structured questionnaire
• *Clifton Assessment - evaluating:
– Physical disability
– Apathy or Inactivity
– Communication difficulties and social disturbance
• Number of elderly in residential homes = 56
• Total of 18 in their own homes
• All information collected by 3 senior nurses
• Total sample = 74, equal no of males/females
• Ages ranged between 65 and 85 years
*(CAPE) (Pattie and Gilleard, 1979)

6. Care Placement - Age Bands
78%
22%
55%
45%
Institutionalized Home-Based-Care
74 yrs  75 yrs

7. Physical Disabilities
• Bathing and Walking - Higher
• Bedriden - Higher (P<0.001)
• Incontinent - Fewer
• Confused - Fewer (P<0.02)
Home-Based-Care elderly when compared
to Institutionalized

8. Disability Characteristics
Apathy Inactivity
Home-Based-Care elderly:
• Establish more good relationships (P<0.01)
• More willing to cooperate (P<0.01)

9. Disability Characteristics
Communication Difficulties
Home-Based-Care elderly:
• Are better communicators
• Have a better understanding

10. Disability Characteristics
Social Disturbances
• More of the Home-Based-Care groups:
– have a better social attitude
– have no difficulty in establishing good
relationships (P<0.01)
– are less objectionable to others
• The Institutional-Home group tend to
have a paranoid attitude
– often accusing others of bodily harm
(P<0.05).

11. Disability Characteristics
Sensory Impairment
Home-Based-Care elderly:
• Have less sensory impairment than the
institutionalized group
– 89% vs 77% had no hearing difficulty
– 67% vs 63% could see with or
without glasses

12. Clifton Assessment

13. Clifton Assessment

14. Clifton Assessment