1. Introduction

Ageing is a universal experience that resulted from significant changes that affect all aspects of the aged person’s life, many of these developed changes faced by elderly people are due to social, psychological, and biological problem that have accumulated over the course of their entire lives ^[1].

Population ageing is a global phenomenon that is a natural evolution of civilization, bringing a number of problems, but also opportunities and challenges. The numbers of elderly people has increased in recent years and many of them need assistance and care in a healthy and safe environment ^[2]. As the population of the aged peoples continues to increase, the demographic transition affect families and societies globally ^{[3, 4, 5]}. It was reported that, in 2006, 64% of the worldwide population aged 60 and older resided in middle and low income countries, and this proportion is projected to increase to nearly 73% by the 2030 ^[4].

According to data from the United Nations Population Division (2008), the percentage of older people in the total population was 15.3 % in 2005 and by 2025; it is estimated to have increase to 20.8% of the total population in developed countries ^[6]. Whereas in Sub-saharan Africa it is estimated that the the population of aged people will increase from 46 million in 2015 to 157 million by 2050 ^[6]. Nigeria has the largest number of the older population in Sub-Saharan Africa, with 6.6 million people aged 60 and over in 2006, and it ranks among the top 20 countries in the world in the size to have this population. The 2014 estimated population of Nigeria shows that elderly people 65 years and above account for 3% of the total Nigerian population, of which females are 2,861,826 and males are 2,621,845 ^[7].

The decline in overall function of people as they aged may result in worsening chronic diseases, culminating in the loss of various life activities ^{[8, 9, 10, 11]}. It is clear that the care of older people globally is an important issue, and the need for governments to adequately make provisions to care for the growing number of older adults is crucial ^{[12, 13, 14, 15]}.

A study by Wolinsky ^[16] established that, most of the elderly people prefer to remain in their various homes than to be cared for at nursing homes. This is because they are able to maintain the integrity of their social network, preserve environmental landmarks and enjoy a higher quality of life.

The type, frequency, and intensity of care/needs of the elderly people varied from assistance for a few hours each week to full-time support ^[17]. The cares spans through three realms: (a) assistance with essential, routine activities such as eating, bathing, dressing, and tasks required to maintain independence, such as preparing meals, managing medications, shopping for groceries, and using transportation; (b) housing; and (c) medical care ^[18]. Equally, care for the elderly can be provided in a variety of settings, including recipients’ homes; group living arrangements such as congregate housing, adult foster care, residential care and assisted living facilities and community settings such as adult daycare and adult day health centres ^[18].

Traditionally, care for the elderly people in Sub-Saharan Africa has been the responsibility of family members and were being provided at homes. In developed nations, elderly care is often being provided by the State as part of the social security for the seniors, in nursing homes or charitable institutions. The reasons being the decreased family size, increasing life expectancy of elderly people, the geographical dispersion of families, the tendency for women to be educated, work outside the home ^[19], changes in the way societies view their elderly and the increase political voice on the elderly people ^[20]. The call for integrated care for the elderly has become a major theme in healthcare reform because of well-documented issues surrounding the poor quality of care being delivered to those with chronic conditions. Health delivery systems and organizations that developed cares in response to meeting acute care needs of the elderly people have been criticized for issues such as fragmentation, wasted resources and poor outcomes for those with chronic conditions ^[21]. Subjective observations revealed poor knowledge and attitude towards caring for the elderly among Funtua residents. It is against this background that this study was design to describe public awareness and perception towards care for the elderly in Funtua, Katsina State, North-west Nigeria.

2. Methods and Materials

Funtua is a town and a Local Government Area (LGA) in Katstina State, Nigeria. Funtua has an area of 448km² and a population of 225,571 at the 2006 census and 420,110 in 2012 estimated census ^[22]. The inhabitants of the local government are predominantly Hausa and Fulani by tribe. There are also Yoruba, Igbo, Southern Kaduna, Tiv, Igala, Idoma, Nupe, Kanuri among others. There are various communities under this LGA and they include Tudun-Wada, BCGA, Jabiri, Makera, Sabon Layi and so on. Their main occupation includes trading, farming and animal rearing. As a result of advancement, the youths get involved in computing, research, transportation, civil service, to mention but a few ^[23], but it remains a traditional setting.

A cross-sectional descriptive survey was used to carry out the study between September and October 2015.

Cluster method was used to select 3 out of the 5 cluster wards and 150 participants were recruited for the study using purposive and convenience sampling techniques.

A questionnaire developed by the authors from review of relevant literature was used for data collection. The questionnaire is divided into four (4) sections was used to collect data. The tool had Sections A, B, C, and D. Section A was on socio-demographic profile of participants:, Section B consisted of questions on knowledge about care of the elderly;, Section C elderly care and Section D on how they would want their elderly to be cared for.The tool was pretested prior to administration, and minor adjustment made. One hundred and forty seven of the 150 questionnaires administered were returned and valid for analysis giving a response rate of 98%.

Data collected from the participants were coded, inputted and analysed using SPSS Version 20 for windows. Categorical data was expressed as frequency and percentages while continuous variables, were expressed as mean ± standard deviation.

3. Results

Data obtained showed that most of the participants were females (n=78, 53.1%) and are married (n=86, 58.5%), and relatively young. (Means age of participants was 31.7 years; SD± 8.27). The participants’ occupational profile showed that they were mainly civil servant (53, 36.1%); business people (44, 29.9%); students (37, 25.2%) and house wives (13, 8.8%). Most participants (77, 52.4%) possessed tertiary qualification (see Table 1).

As indicated in Table 2, majority (126, 85.7%) of participants reported having at least an elderly person in their homes that they care for; most (132, 89.8%) of them depicts that they were aware about the care required by the elderly people. In terms of the participant’s knowledge on the concept of care for the elderly, 62.9% of them signified that fulfillment of the special needs and requirements that are unique for aged people as the concept that defined care for the elderly. On the benefits of caring for the elderly, vast majority (96, 87.3%) of participants affirmed that it improves the quality of life of the elderly, and makes them feel beloved (91, 82.7%).

Table 1. Participant’s socio-demographic data (n=147)

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Table 2. Participants awareness on the caring for the elderly at home

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Eight variables were used to obtained data from the participants about their perceived care towards the elderly (Table 3). Majority (133, 90.5%) of participants affirmed that they like caring for the elderly at home, preferring their elderly ones to stay with them (131, 91.6%). In addition, (115, 82.1%) of the participants would not want their elderly people to be cared forin institutions such as nursing homes. However, a good number (124, 88.6%) of participants indicated that they need additional assisstance in caring for their elderly ones. The findings also revealed that most (84, 57.1%) of participants perceive that other family members would also prefer that the elderly be cared at home.

Table 3. Participants perceived care towards the elderly (n=147)

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4. Discussion of Findings

The results of this study shows that majority (86%) of participants reported that they have at least an elderly person at home whom they cared for in various ways. Furthermore, participants were knowledgeable about the concept of caring for the elderly as they posed that “fulfillment of the special needs and requirements that are unique for aged people” as the concept that defined care for the elderly. This finding is consistent with the study of Ufuomaoghene ^[24] in two selected teaching hospitals in South Western Nigeria which reported that, physical nursing care activities such as bathing, dressing up, hair care, oral toileting, foot wears, care of the pressure areas and passive exercise were mostly provided by the patients family members. In addition, many other studies ^{[25, 26, 27, 28]} were in agreements with the present study findings in these regards.

The findings of this study also reveals that 91% of participants prefered their elderly peoples to live with them at home than to be nursed elsewhere, although, mojority (89%) of participants indicated the need for a domestic assisstant in caring for their elderly people. Similar findings from other studies ^{[19, 28]} shows that participants viewed older adults as a source of wisdom and guidance based on their varied life experiences and so preferred to keep in their home environments. Moreover, older people usually remain with their children and other family members until their death with care usually being given by the family members no matter how seriously ill or disabled their aged relative may be. Research studies ^{[29, 30, 31]} established that feelings of guilt among the society prevent most people from moving their aged parents to a nursing home or other aged care facility, even if they believe that their parents may be given better care there.

5. Conclusion

The study shows high level of awareness and positive attitude towards caring for the elderly. Despite the increasing number of the aged in the relatively semi-urban settlement, care of the elderly is preferably (and it is still actually) situated in homes, with extended families still opting for home against institutionalized care.

6. Recommendations

From the above findings, the following recommendations are made:

Health workers particularly nurses should health educate the community on the importance of caring for the aged and also enlightened them on some sign, symptoms and illnesses associated with ageing, for prompt monitoring and referral for proper care and treatment.

Government should equip the lay people with adequate knowledge on the care of the elderly to forestall any unintentional neglect from caregivers at their homes. The media can be very useful in this regards.

Government at all level should still establish geriatric unit in every hospital, and primary health care centres especially those in rural areas to enable easy accessibility to health care by the elderly ones for those who may opt for these alternatives or when the need arises for the aged being cared for at home require expert care.

7. Limitation

The narrow scope of this study limits the generalisability of the findings to all areas in the study environment. Supports from researchers and organisations may enhance more coverage and diverse methological appraoch for more generalisable findings.

Acknowledgement

The authors wish to thank Messrs Mr. Adeleke IT of the Department of Health Information Management, Federal Medical Centre Bida, Mr. Samaila Balarabe Ayuba, and Mrs. Yusuf Ibrahim Lateefah of Department of Nursing Services, Ahmadu Bello University Teaching Hospital, Zaria for their comments on the final manuscript. The comments of Nurse Mohammed Ibrahim Okeme of School of Post Basic Anaesthesia, Ahmadu Bello University Teaching Hospital, Tudum-Wada, Zaria is genuinely acknowledged.

Competing Interest

The authors declare that no competing interests.

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