Global Journal of HUMAN-SOCIAL SCIENCE: C

Sociology & Culture

Volume 17 Issue 2 Version 1.0 Year 2017
Type: Double Blind Peer Reviewed International Research Journal
Publisher: Global Journals Inc. (USA)
Online ISSN: 2249-460x & Print ISSN: 0975-587X

Life after Life: An Assessment of Elderly Institutional Care in

Addis Ababa City (in Particular Reference to Mekedonia Home
for the Elderly and Mentally Disabled)
By Tewodros Habtegirorgis Zikarge
Wolaita Sodo University
Abstract- Given the economic advancements and well-being leading people to live longer, older people
living in developing nations particularly in Africa are suffering from multi-faceted problems. One of the
possible interventions to curb the suffering of the elderly population is an institutional caring system. This
intervention is of paramount importance in time of crises like family lose, health complication and poverty
driven street life. Today in Ethiopia, it is becoming a day to day scene to see numerous elders begging in
the streets for their living. Although it is in a limited effort and way, there are institutional care schemes in
Ethiopia (Segniwork, 2014).This study tries to assess the institutional care provided for the elderly and
residents perception of the quality of care provided by Mekedonia Home for the Elderly and Mentally
Disabled. The study used mixed-method approach (a concurrent nested strategy). The survey which was
employed in this study was focused on gathering information on the types of care, levels of care and the
residents’ perception of the quality of care provided. In-addition, in-depth interviews and FGDs( Focus
Group Discussions) were conducted with purposively selected residents and key informant interview with
key administrative staffs who were in charge of providing care and support, focusing on the available
resources and problems associated with care and support.
Keywords: elderly, institutional care, residents.
GJHSS-C Classification: FOR Code: 370199

LifeafterLifeAnAssessmentofElderlyInstitutionalCareinAddisAbabaCityinParticularReferencetoMekedoniaHomefortheElderlyandMentallyDisabled
Strictly as per the compliance and regulations of:

© 2017. Tewodros Habtegirorgis Zikarge. This is a research/review paper, distributed under the terms of the Creative Commons
Attribution-Noncommercial 3.0 Unported License http://creative commons.org/licenses/by-nc/3.0/), permitting all non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Life after Life: An Assessment of Elderly
Institutional Care in Addis Ababa City (in
Particular Reference to Mekedonia Home for the
Elderly and Mentally Disabled)
Tewodros Habtegirorgis Zikarge

2017
Abstract- Given the economic advancements and well-being circumstances elderly people lose their independent
leading people to live longer, older people living in developing livings (Luppa& Tobias,2009).

Year
nations particularly in Africa are suffering from multi-faceted Nowadays, elderly people are encountered with
problems. One of the possible interventions to curb the various problems this is due to limited government
suffering of the elderly population is an institutional caring
social welfare schemes, weakening of traditional family 41
system. This intervention is of paramount importance in time of
crises like family lose, health complication and poverty driven
and community support. Thus it is common to see
elderly who have the knowledge and skill to help not

Global Journal of Human Social Science ( C ) Volume XVII Issue II Version I

street life. Today in Ethiopia, it is becoming a day to day scene
to see numerous elders begging in the streets for their living. only themselves but others facing serious problems and
Although it is in a limited effort and way, there are institutional resorting to begging and sleeping on streets (Ministry of
care schemes in Ethiopia (Segniwork, 2014).This study tries to Labor and Social Affairs, 2006, p4).
assess the institutional care provided for the elderly and In Ethiopia, elderly people make up a relatively
residents perception of the quality of care provided by small portion (2.8%) of the total population, and
Mekedonia Home for the Elderly and Mentally Disabled. The traditionally their main source of support has been the
study used mixed-method approach (a concurrent nested
household and family, supplemented in many cases by
strategy). The survey which was employed in this study was
focused on gathering information on the types of care, levels
other informal mechanisms, such as kinship networks
of care and the residents’ perception of the quality of care and mutual aid societies (Ministry of Labor and Social
provided. In-addition, in-depth interviews and FGDs( Focus Affairs, 2006, p4).
Group Discussions) were conducted with purposively selected Currently, at the national level, government and
residents and key informant interview with key administrative non-government organizations as well as association of
staffs who were in charge of providing care and support, retired persons have started to make greater efforts in
focusing on the available resources and problems associated tackling problems of the elderly. One of the solution, as
with care and support. The findings of the study revealed that the elderly became in such a condition, is the
there are food, clothing, shelter, recreational and health care
development of institutions to care for them (Adamek &
services that are actually provided by the institution and most
sample residents had ranked each service provision as good
Alemnesh, 2014). These elderly care institutions which
and excellent. The study also revealed that providing basic are private or humanitarian, voluntary and charity

-
services to the neediest elders is the foundation goals of the associations suchas Mekedonia Home for the Elderly
institutions. And also understands that the service provision and Mentally Disabled, are assumed to be significant to
has changed the life situation of the resident elders. One of the increase the quality of life of the elderly with good quality
possible interventions to curb the problems of vulnerable of care.
populations (such as elderlies, children and women’s) is an Mekedonia Home for the Elderly and Mentally
institutional care system. This intervention is of paramount Disabled (MHEMD) is an indigenous non-governmental,
importance in time of crises like family lose, health
non-profit charity organization, founded on 7th January
complication and poverty driven street-life.
2010. The purpose of the institution is to support elderly
Keywords: elderly, institutional care, residents.
people and people with disabilities who otherwise have
I. Introduction no means of survival by providing them with shelter,
clothing, food, and other basic services.

M
ost elderly prefer to remain in their homes where Mekedonia is a residential home care unit that
they are able to maintain the integrity of their is more than just a provider of support; it is also the
social network, preserve environmental permanent dwelling place of residents. It has the
landmarks and enjoy a higher quality of life. However, potential, therefore, to in fluence and affect many
due to complex socio-economic and political aspects of the residents’ daily lives beyond health and
Author: Lecturer at Wolaita Sodo University, Department of Sociology.
functional ability. It is important, therefore, that
e-mail: girumfekadu25@gmail.com researchers, policy-makers and other interested parties

© 20 17 Global Journals Inc. (US)

 Life after Life: An Assessment of Elderly Institutional Care in Addis Ababa City (in Particular Reference to
Mekedonia Home for the Elderly and Mentally Disabled)

recognize and understand the important elements that reduce the sampling error to zero (Yeraswork, 2010,
constitute a good quality of care in elderly home care in p135).
order to put in place mechanisms that will ensure that Sampling was conducted as follows: Firstly, the
this objective is achieved. population was partitioned into homogenous subsets
It is in this regard that this study attempts to i.e. the sampling frame (the roster) was divided between
assess the types of care being provided by Mekedonia that which contains the names of (males and females),
and residents’ rating of the actual care provided, taking (residents with physical disability and the physical
the institution and the elderly care recipients as a frame ability), and then appropriate random samples were
of study. drawn from each of the subsets.
Likewise, according to the statistical figures of
II. Materials and Methods the institution, from the total residents of 850, 320 of
them were mentally disabled hence, they were thought
a) Research Design
as they provide less information for the study; they are
The general principle of research design is that
removed from the sampling frame. Out of the remaining
the research strategy or strategies, and the methods
2017

530 residents, with 95 % confidence interval and by 5%

or techniques employed must be appropriate for the sample size proportionate, a total of 175 sample
Year

questions made by the researcher wants to answer residents (using the online sample size calculator) were
(Robson, 1993:39). This study employed, cross- estimated. The selection process was conducted
42 sectional survey design so as to obtain information through random numbers generator in SPSS Version 20)
about the present situation which is related to the issue from each of the sampling categories (i.e. sex and
under study. Data’s were collected at one point in time
Global Journal of Human Social Science ( C ) Volume XVII Issue II Version I

disability status). To do so, a list of residents’ (sample

from a randomly selected samples of the population. frame) was obtained from the institutions administrative
However, the cross sectional survey design was made office.
to approximate longitudinal survey design, as In summary, from each of stratifying categories
questionnaire elements that refer to the past were of physically-abled male residents (N=213), physically-
included. That is, while the cross-sectional survey is disabled male residents (N=198), and physically abled
used to obtain data regarding the service and supports female residents (N=72) and 47 physically disable
delivered to residents and the benefits obtained from the female residents, 53, 54, 37, & 29 sample residents
were randomly selected from respective populations by
participation, the approximating longitudinal survey is
used to provide data relevant to their past situations. using SPSS.
III. Results and Discussion
b) Methods of Data Collection
This study, utilized both quantitative and This section presents the actual care provisions
qualitative methods of data collection and analysis to of Mekedonia and it explains the types and levels of
obtain the strengths from both methods and to address service provisions as it is leveled by the residents
their weakness by using strengths from each other. It themselves. The presentation below summarizes the
employed methodological triangulation of various types and levels of care provided:
methods of data collection and analysis in order to a) Actual care and support provision
assure the validity and reliability of research results, and Different services are provided to residents in
-

to effectively address different objectives of the Mekedonia. The main services provided for the admitted
research. While survey questionnaire was utilized as elders, includes; Shelter/bed rooms/, food, health care
technique of collecting quantitative data, the qualitative service, hygiene facilities, assisted caring, clothing and
was collected using interview, FGD and observation. funeral ceremonies when they died. The other
supporting services though it is not well enough as itwas
c) Sampling Technique
indicated by the coordinator includes, recreational
For the purpose of achieving the objectives of
facilities such as, TV room facility (four in four meeting
the study, stratified random sampling techniques were halls), and indoor games.
used to select sample residents. Stratified sampling is a The table below indicates the number of
sampling design in which separate samples are drawn physically disabled respondents who have been
from different segments of a population in order to provided with aid equipment and are actually using the
ensure the proportionate representation of each of the provided aid equipment. Likewise, all sample
segments in the overall sample (Yeraswork, 2010, respondents were asked to mention the type of aid
p135). equipment’s they use in the institution. Accordingly,
For instance, this study was undertaken on the ramps comes first with 48 frequencies, followed by
elderly & disabled population of institutional care. Thus, walking aid equipment with frequencies of 45 and
disability status and sex are very important variables and handrails with a frequencies of 17 respectively. The
along these two variables thereby it was possible to smallest use of aid equipment wasramps and electric
employ stratified sampling technique which can nearly wheelchairs with a frequencies of 2 and 3 respectively.

© 2017 Global Journals Inc. (US)

 Life after Life: An Assessment of Elderly Institutional Care in Addis Ababa City (in Particular Reference to
Mekedonia Home for the Elderly and Mentally Disabled)

Table:-1: Frequency and percentage distribution of physically impaired respondents who commonly use aid
equipment at Mekedonia

Use of aid
Yes No Total
equipment
Walking aid 45 (25.7) 130 (74.3) 175(100)
equipment 48 (27.4) 127 (72.6) 175(100)
Manual wheelchair 3 (1.7) 172 (98.3) 175(100)
Electric wheelchair 17 (9.7) 158 (90.3) 175(100)
Handrails along 2 (1.1) 173 (98.9) 175(100)
corridors 11 (6.3) 164 (93.7) 175(100)
Ramps 7 (4) 168 (96) 175(100)
Special eating
utensils

2017
Special writing
utensils

Year
Source: Researcher’s survey data (2016)
Institutional care has the potential to in fluence facilities at Mekedonia, so that it is possible to 43
residents’ lives either positively or negatively on understand how residents are engaged in meaningful
outcomes that include more than just health. It shapes andentertaining activities. Respondents were asked

Global Journal of Human Social Science ( C ) Volume XVII Issue II Version I

where elderly live, how they live, whom they see, what about, whether there has been any entertaining
they do, and the relationships transpiring within families programs which were produced and organized by
and communities (Kane, 2001). Therefore it is very Mekedonia and if they are entertained.
important to study the availability of entertainment
Table 3: Frequency and percentage distribution of respondents’ by every entertaining program provided by
Mekedonia

Variable No. %
Yes 132 75.4
Was there any entertaining program
provided by Mekedonia? No 43 24.6

Total 175 100.0

Source: Researchers’ survey data (2016)

As it is seen in the above table (table 3), most of Accordingly, television comes first with 175 frequencies,
the sample respondents’ i.e. 75.4% has mentioned as followed by Video or DVD with frequencies of 140 and
there was entertaining programs produced by Newspapers and magazine with a frequencies if 136

-
Mekedonia. Whereas, 24.6% of the samples has replied respectively.
as there was no entertaining programs provided by It is summarized in the following table below:
Mekedonia.
Sample respondents were also asked about the
availability of entertainment facilities at Mekedonia.

Table 4: Frequency and percentage distribution of Communal recreational facilities at Macedonia

Television 175(100) 0 175 (100)175

Newspapers or magazine 136 (77.7) 39 (22.3) (100)
Library or book lending service 15 (8.6) 160 (91.4) 175 (100)
Video or DVD 140 (80) 35 (20) 175 (100)
Indoor games 121 (69.1) 54 (30.9) 175 (100)
Musical instruments 11 (6.3) 164 (93.7) 175 (100)
Coffee or tea making facilities 1 (0.6) 174 (99.4) 175 (100)

© 20 17 Global Journals Inc. (US)

 Life after Life: An Assessment of Elderly Institutional Care in Addis Ababa City (in Particular Reference to
Mekedonia Home for the Elderly and Mentally Disabled)

a) Residents rating of the available services

Table 5: Residents rating of the available services provided at Macedonia
N=175)

Actual care provision at Mekedonia Level of care Frequency Percentage

Poor 12 6.9
Fair 4 2.3
Good 95 54.3
Provision of food service Excellent 64 36.6
Total 175 100
Poor 1 0.6
Fair 31 17.7
Provision of clothes Good 85 48.6
Excellent 58 33.1
2017

Total 175 100

Poor 4 2.3
Year

Fair 8 4.6
Provision of health care service Good 71 40.6
Excellent 79 45.1
44 Total 162 92.6
Poor 52 29.1
Global Journal of Human Social Science ( C ) Volume XVII Issue II Version I

Fair 55 31.4
Availability of adequate bed rooms Good 47 26.9
Excellent 21 12
Total 175 100
Poor 53 30.3
Fair 61 34.9
Availability of adequate bath rooms Good 39 22.3
Excellent 22 12.6
Total 175 100
Source: Researcher’s survey data (2016)
All sample residents were asked if they believe sample respondents’, 48.6% has rated the clothing
that there is adequate food service at Mekedonia. And service as good, 33.1% of the samples has rated as
out of the total 175 sample residents, 163(93.1%) of the excellent, whereas, 17.7% has rated as fair and only one
samples believe that there is adequate food service, or 0.6% of the sample respondents’ has rated the
whereas, the remaining 12(6.9%) believe that there is no clothing service as poor. Moreover from the above data
adequate food service at Mekedonia. Furthermore, it is possible to conclude that, even though residents are
respondents were asked to rate the available food not interested with the clothes they are receiving but,
service at Mekedonia. they have a positive outlook for the clothing service.
-

As shown in the table above, all respondents The researcher was also interested to know
were asked to rate the level of food service despite their whether the provided clothes fulfill the interest of
differential outlook about the presence of adequate food residents (i.e. residents were asked if the provided
service at Mekedonia. Likewise, 54.3% of sample clothes were distributed based on their needs). Thus, it
respondents’ had rated the food service as good, 36.6% is 41.7% of the total sample respondents’ that are
has rated the food service as excellent, whereas, 6.9 interested in the provided clothes, whereas, 58.3% of
and 2.3 percent has rated the food service as poor and the sample respondents’ replied as they are not
fair respectively. Therefore, from the above data it is interested in the given clothes. Accordingly, from the
possible to conclude that respondents’ had a positive above data we can understand that though all of the
outlook for the food service at Mekedonia. residents are benefited from the provided clothes but
Respondents’ were asked whether the there is disparity in terms of their specific needs for the
institution provide them clothes. Likewise, all the provided clothes. Hence the clothes are acquired from
respondents’ 175(100%) has replied as they are volunteer personalities it might not fulfill their specific
provided with clothes. In addition, respondents were needs. As such, most of them are not interested with the
asked whether the provided clothes fulfill their interests provided clothes.
(i.e. residents were asked if the provided clothes are Mekedonia is serving residents in four
distributed based on their needs). compounds, one owned and three rented compounds.
As such, all sample respondents were asked to The bed rooms inhibit between eight and forty (in
rate the clothing service at the institution. Most of the temporary shelters) residents. There are bed rooms
© 2017 Global Journals Inc. (US)
 Life after Life: An Assessment of Elderly Institutional Care in Addis Ababa City (in Particular Reference to
Mekedonia Home for the Elderly and Mentally Disabled)

constructed with metal sheets used as temporary believe that there is adequate bath rooms at Mekedonia.
residences to receive the needy elders whose Out of the total 175 sample respondents 100 samples
admission couldn’t be delayed until the construction of (57.1%) has believed that there is no adequate bath
regular residence. Beds in Mekedonia are double stairs. room at Mekedonia. Whereas, the remaining 75(42.9%)
Elders are assigned to the ground bed and younger of the samples has believed that there is adequate bath
elders are assigned to sleep on the upstairs beds. As it rooms. Furthermore, respondents were also asked to
is indicated in the table above, all sample residents were rate the available bath rooms.
asked if they believe that there is adequate bed rooms As it is visible in the above given data, all
at Mekedonia. And out of the total 175 sample sample respondents were asked to rate the available
respondents 118 samples (67.4%) believe that there is bath room facility regardless of their differential outlook
no adequate bed room at Mekedonia whereas, the about the adequacy of the bath rooms. Likewise, 34.9%
remaining 57(32.6%) of the samples believe that there is of sample respondents’ had rated the available bath
adequate bed rooms. rooms as fair, 30.3% has rated as poor. It is, 22.3 and
Furthermore, respondents were also asked to 12.6 percent of the sample respondents who has rated

2017
rate the available bed rooms. Despite respondents’ the available bathe rooms as good and excellent

Year
differential response about the adequacy of bed rooms, respectively. Therefore, from this data, it is possible to
all sample respondents were asked to rate the available conclude that residents had unfavorable outlook for the
bed rooms. Likewise, 31.4% of sample respondents’ existing bathe rooms, this is because most of them
had rated the available bed rooms as fair, 29.7% has (57.1%) believe that there is no adequate bathe rooms 45
rated as poor, whereas, 26.9 and 12 percent has rated and the existing bathe rooms lack quality which is nearly

Global Journal of Human Social Science ( C ) Volume XVII Issue II Version I

the available bed rooms as good and excellent 65.2%.
respectively. Therefore, from this data, it is possible to Maintaining a good health and access to health
conclude that residents had unfavorable outlook for the care is a core concern of elderly people everywhere. As
existing bed rooms this is because most of them literatures indicate, the growing number of elderly
believed that there is no adequate bed rooms and the persons is accompanied by mental illnesses and health
existing bed rooms lack quality. problems that need even long term care and support
This study had also tried to find out residents system. Regarding the health care service at
past sleeping circumstances, in order to have a clear Mekedonia, all sample respondents’ were asked if
understanding of their present outlooks of the service Mekedonia is having a health care service or if it has a
they are receiving. In doing so all sample respondents health post or a clinic and if they have been benefited
were asked, how they use to sleep before they were from it. Accordingly, all of the sample respondents’
admitted in to Mekedonia. Most of the respondents i.e. know that Mekedonia has a clinic. And it is 162(92.6%)
66.3% replied that they were sleeping alone and the of the sample respondents’ who has replied as they
remaining 33.7% had replied as they use to sleep have been benefited from the available clinic. Whereas,
together with others and most of the respondents’ that is it is only 13(7.4%) of the sample respondents’ has
68% use to sleep anywhere in the street whereas, few of replied as they have never used the available clinic at
them i.e. 2 (1.1%) of the respondents use to sleep with Mekedonia.
grandchild or children. Furthermore, those 162 (92.6%) of the sample

-
It’s important to combine and discuss about the respondents’ who had been benefited from the available
respondents’ past and present sleeping situation in clinic, were asked to rate the available health care
order to come up with a clear understanding of the service. As it can be seen from the data, 92.6% of the
resident’s rating of the available bed rooms at respondents’ have been treated or benefited from the
Mekedonia. As it is indicated in table, 31.9 and 29.7 available health care service. Whereas, 7.4% of the
percent of the respondents has leveled the situation of respondents’ has never been benefited. Consequently,
bed rooms at Mekedonia as fair and poor respectively out of 92.6% of sample respondents, who has been
which is more or less unfavorable outlook. Whereas, benefited from it, 48.8% of the sample respondents’ has
majority of i.e. 68 and 12 percent of the respondents has rated the available health care service as, it is excellent,
replied as they were living on the streets and in church 43.8% of the sample respondents’ has rated as it is
yards respectively which is nearly 80 percent. Therefore, good. Whereas, 4.9% rated as it is good and only four or
from this data, in particular and from the two data’s in 2.5% of the sample respondents’ has mentioned as it is
general, it is possible to conclude that even though, poor. Moreover, from the data provided we can
residents had come up from the worse sleeping conclude that, most of the residents are more satisfied
situation still the existing sleeping rooms are not by the health care service provided by Mekedonia.
adequate and the situation of the bed rooms are Also as the information gained from in depth
uncomfortable for residents as it is expected to be. interview, there is referral system for the patients in need
The other service provided by Mekedonia was of extra medications, the patient will get referred to other
bath room and all sample residents were asked if they government hospitals like Zewditu, Menelik II,
© 20 17 Global Journals Inc. (US)
 Life after Life: An Assessment of Elderly Institutional Care in Addis Ababa City (in Particular Reference to
Mekedonia Home for the Elderly and Mentally Disabled)

TekurAnbessa, Zenebework, Yekatit 12, and St. Paulos. home. They were not discomforted with their stay rather;
The institution has special agreement with these they were enjoying their communal living. As a result, of
hospitals. Volunteer medical doctors will also come to institutional living they are able to enjoy and connect to
the clinic on Tuesday, Thursday and Sunday and give the community regardless of gender, class, and
services to those who need medication. Saturday religious differences.
morning psychiatrists came to the clinic and give
b) Recommendation
psychological services to mentally ill care recipients.
One of the health care givers has explained that  Institutional care recipients, especially those who
most of the care recipients have poor health and usually are suffering from frailty want to be addressed in a
visit the clinic. Some other nurses has also added, as polite, friendly and appropriate manner and treated
causes of frequent health problems are age related. with respect for their personal privacy, hygiene and
It was also revealed that most of the older appearance, choice of clothes and furnishings and
persons are facing sight, mobility and hearing problems, access to appropriate care and assistance with
some of them gastritis and others suffered mental eating, drinking, washing, toilet and other daily
2017

illness. These illnesses were treated by the medium activities are required.
clinic in the institution and by the referral hospitals.  As institutional elders are the most segregated and
Year

forgotten segment of the society, it is an ideal

IV. Conclusion and Recommendations practice area where professional values and
46 practice principles are applied in real life.
a) Conclusion
 Multiples of practice tasks are vacant waiting for the
With a growing pressure from destitute aging
Global Journal of Human Social Science ( C ) Volume XVII Issue II Version I

attention of professionals, practitioners and

population on social & health care use and expenditure,
advocates. Caring, counseling, training, advocating
it is very important to systematically assess the nature
and institutional management are all needs the
and quality of institutional based care for the elderly, and
involvement of gerontologists, sociologists, social
discover the effects of institutional living upon elder
work practitioners and other professionals.
people themselves in order to find out whether
 In addition to recognizing elders as one important
institutions for the elders were necessary in our society,
part of the society, expanding policies and
and if so what form they should take.
programs that can address better institutional care
From the study findings, it is possible to draw a
and community support, the social care of elders,
definite conclusion that institution based care and
housing, and service access needs of older people
support service which focuses on the needy elders have
is required.
rescued the late life situations of the elders. While the
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