A Conceptual Structure of Care Dependency in Home-Dwelling Indonesian Older Adults

This study aims to develop a conceptual structure of care dependency for home-dwelling Indonesian older adults and to clarify the pre-specified domain that fits with the Indonesian context. The first step of the research was a review of published tools developed to assess care dependency or dependency. The instruments were reviewed to develop the pre-specified domain of care dependency in older adults, and later analysed using Orem's self-care deficit nursing theory (SCDNT). Electronic databases such as MEDLINE'PubMed, CINAHL, and EMBASE were used to obtain journal articles to identify clinical studies that used the care dependency instrument. The search began by using keywords such as "care dependency", "care dependency scale" and "care dependency measurement in older adults" followed by searching through citation and reference search. The second step was to conduct a descriptive, qualitative study with 30 participants, using a semi-structured interview guide generated from the first step. The pre-specified domains of care dependency were found to be organized into eight domains, namely (1)activity; (2) nutrition; (3) skin and hygiene; (4) psychosocial; (5) spiritual; (6) sleep and rest; (7) elimination; and (8) health care practices. The results of the second step showed that those eight domains were fit to the Indonesian context. In conclusion, it was found that the conceptual structure can be used to develop a scale to measure home-dwelling older adults' care dependency in future research, as well as primary care curricula to improve nursing care for the older adults who are care dependent and living at home. Moreover, it also can be used to develop programs to address problems experienced by a dependent older adults living in the community.