Menjaga Warga emas uzur (WEU) di rumah boleh memberi pelbagai cabaran dan menjejaskan keperluan penjaga tidak formal. Di Malaysia, tidak banyak kajian difokuskan dalam kalangan penjaga. Justeru, kajian ini bertujuan untuk meneroka keperluan tidak dipenuhi (KTD) dalam kalangan penjaga WEU di rumah. Reka bentuk kajian ini adalah secara kualitatif dengan pendekatan fenomenologi. Kajian ini telah dilaksanakan di daerah Hulu Langat, Selangor menggunakan jenis persampelan bertujuan dengan kriteria inklusi. Seramai enam orang penjaga WEU telah berjaya ditemu bual dan dikenal pasti melalui Persatuan Pesara UKM, Pusat Aktiviti Warga Emas (PAWE) UKM dan Persatuan Penduduk setempat. Data kajian telah dianalisis secara tematik menggunakan analisis manual. Hasil kajian menunjukkan lima tema KTD dialami penjaga iaitu kesejahteraan emosi, masalah kesihatan, keperluan sosial, rehat dan tidur serta impak pekerjaan. Kesemua penjaga mengalami sekurang-kurangnya satu KTD dan kesejahteraan emosi merupakan KTD paling kerap dilaporkan. Terdapat penjaga yang mengalami stres sehingga meninggalkan kesan negatif kepada tubuh WEU. Segelintir pula mengalami masalah kesihatan termasuk kemurungan dan kebimbangan, kurang berat badan, sakit pinggang dan tangan. Keperluan sosial penjaga juga sangat terhad dan kebanyakan mereka tidak melibatkan diri dalam aktiviti kemasyarakatan. Penjaga juga tidak menikmati rehat dan tidur secukupnya. Terdapat penjaga yang berhenti kerja untuk memberi fokus kepada penjagaan. Kesimpulannya, KTD dalam kalangan penjaga sangat memberi kesan kepada diri mereka dan warga emas yang dijaga. Malah masalah ini berisiko tinggi menyumbang kepada kes penderaan yang lebih serius. Justeru sokongan kepada penjaga ini perlu diberi perhatian oleh semua pihak agar KTD dalam kalangan penjaga dapat dikurangkan.

Kata kunci: Keperluan tidak dipenuhi; penjaga; warga emas; uzur; tidak formal

Abstract: Caring for frail elderly (WEU) at home can be challenging and affects the needs of informal caregivers. In Malaysia, not many studies were focused on caregivers. Therefore, this study aims to explore the unmet needs (KTD) among frail elderly caregivers at home. The design of this study is qualitative with a phenomenological approach. This study was carried out in the district of Hulu Langat, Selangor using a sampling technique with inclusion criteria. A total of six frail elderly caregivers were successfully interviewed and identified through the UKM’s Pensioners Association, UKM’s Senior Citizens Activity Centre (PAWE) and the Local Residents' Associations. The data was analyzed thematically using manual analysis. The results of the study showed that five themes of KTD were experienced by caregivers in terms of emotional well-being, health problems, social needs, rest and sleep as well as work impact. All caregivers had at least one KTD and emotional well-being was the most frequently reported. There are caregivers who are so stressed and leave a negative impact on the WEU’s body. A few caregivers suffer from health problems including depression, anxiety, underweight, back pain and hand pain. Their social needs are also very limited and most caregivers are not involved in community activities. Caregivers also do not enjoy adequate rest and sleep. There are caregivers who quit their jobs to focus on caregiving. In conclusion, KTD among caregivers has a great impact on them selves and their WEUs. In fact, this problem has a high risk of contributing to more serious cases of abuse. Therefore, support for these caregivers needs to be paid attention to by all parties so that the KTD among caregivers can be reduced.

Keywords: Unmet needs; caregivers; elderly; frail; informal

References

Abdullah, F., Ah, S. H. A. B. & Mohamad, M. S. (2015). Cabaran dalam penjagaan tidak formal di Malaysia. Journal of Sarjana, 30(2), 41-56.

Akgun-Citak, E., Attepe-Ozden, S., Vaskelyte, A., van Bruchem-Visser, R. L., Pompili, S., Kav, S., ... & Mattace-Raso, F. U. (2020). Challenges and needs of informal caregivers in elderly care: Qualitative research in four European countries, the TRACE project. Archives of Gerontology and Geriatrics, 87, 103971.

Alavi, K., Sail, R. M., Idris, K., Samah, A. A., & Chan, C. (2011). Keperluan sokongan emosional dalam kalangan anak dewasa yang menjaga warga tua. e-BANGI:Journal of Social Sciences & Humanities, 6(1), 102.

Andrew, M. K., Fisk, J. D., & Rockwood, K. (2012). Psychological well-being in relation to frailty: A frailty identity crisis? International Psycho-Geriatrics, 24(8), 1347–1353. https://doi:10.1017/S1041610212000269

Clarke, V., & Braun, V. (2013). Successful qualitative research: A practical guide for beginners. Successful Qualitative Research, 1-400.

Denham, A. M., Wynne, O., Baker, A. L., Spratt, N. J., Turner, A., Magin, P., ... & Bonevski, B. (2020). An online survey of informal caregivers’ unmet needs and associated factors. PLoS One, 15(12), e0243502. https://doi.org/10.1371/journal.pone.0243502

Desai, M. M., Lentzner, H. R., & Weeks, J. D. (2001). Unmet need for personal assistance with activities of daily living among older adults. The Gerontologist, 41(1), 82-88.

Diwan, S., & Moriarty, D. (1995). A conceptual framework for identifying unmet health care needs of community dwelling elderly. Journal of Applied Gerontology, 14(1), 47-63.

Endal, G. G., Søvde, B. E., Terum, T. M., & Andersen, J. R. (2023). Bruk av Share-FI til å avdekke skrøpelegheit ved kognitiv svikt. Sykepleien Forskning (Oslo), 18(92075), e-92075. https://doi.org/10.4220/ Sykepleienf.2023.92075

Faizal, N., Alavi, K., & Ismail, N. A. (2023). Meneroka Beban Penjagaan dan Kesejahteraan dalam kalangan Penjaga Warga Emas Terlantar. Akademika, 93(3), 169-180. https://doi.org/10.17576/akad-2023- 9303-13

Figueiredo, M. D. L. F., Gutierrez, D. M. D., Darder, J. J. T., Silva, R. F., & Carvalho, M. L. D. (2021). Formal caregivers of dependent elderly people in the home: challenges experienced. Ciência & Saúde Coletiva, 26, 37-46. https://doi.org/10.1590/1413-81232020261.32462020

Fried, L.P.,Tangen,C.M.,Waltson, J.,Newman,A.B.,Hirsh,C.,Gottdiener, J., Seeman, T., Tracy, R., Kop, W. J., Burke, G., & McBurnie, M. A. (2001). Frailty in older adults: Evidence for a phenotype. Journal of Gerontology: Medical Sciences, 56.A, M146–M156.

Gemito, L., Alves, E., Moreira, J., Marques, M. F., Caldeira, E., Ferreira, R., ... & Lopes, M. (2024). Programmes Addressed to Informal Caregivers’ Needs: A Systematic Literature Review. Geriatrics, 9(3), 71. https://doi.org/10.3390/ geriatrics9030071

Gobbens, R. J., Luijkx, K. G., Wijnen-Sponselee, M. T., & Schols, J. M. (2010). Toward a conceptual definition of frail community dwelling older people. Nursing outlook, 58(2), 76-86.

He, S., Craig, B. A., Xu, H., Covinsky, K. E., Stallard, E., Thomas III, J.,Zach, H. & Sands, L. P. (2015). Unmet need for ADL assistance is associated with mortality among older adults with mild disability. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 70(9), 1128-1132. https://doi.org/10.1093/gerona/glv028

Hermsen, L. A., Hoogendijk, E. O., van der Wouden, J. C., Smalbrugge, M., Leone, S. S., van der Horst, H. E., & Dekker, J. (2018). Self-perceived care needs in older adults with joint pain and comorbidity. Aging Clinical and Experimental Research, 30, 449-455. https://doi.org/10.1007/s40520-017-0795-7

Hinders, J. A. S. (2019). Unmet Support Needs of Informal Caregivers of Older Adults (Doctoral dissertation, Walden University).
Hoogendijk, E.O., Muntinga, M.E., van Leeuwen, K.M., van der Horst, H.E.,

Deeg, D.J., Frijters, D.H., Hermsen, L.A., Jansen, A.P., Nijpels, G. and van Hout, H.P., (2014). Self-perceived met and unmet care needs of frail older adults in primary care. Archives of gerontology and geriatrics, 58(1), 37-42.

Hughes, T., Black, B., Albert, M., Gitlin, L., Johnson, D., Lyketsos, C., & Samus, Q. (2014). Correlates of objective and subjective measures of caregiver burden among dementia caregivers: Influence of unmet patient and caregiver dementia-related care needs. International Psychogeriatrics, 26(11), 1875-1883. https://doi.org/10.1017/S1041610214001240.

Jabatan Perangkaan Malaysia. (2022). ANGGARAN PENDUDUK SEMASA, MALAYSIA, 2022 (2).pdf. https://www.dosm.gov.my/uploads/publications/20221006100333.pdf

Janssen, N., Handels, R. L., Köhler, S., Gonçalves-Pereira, M., Marques, M. J., Irving, K., ... & Actifcare Consortium. (2020). Profiles of met and unmet needs in people with dementia according to caregivers’ perspective: Results from a European multicenter study. Journal of the American Medical Directors Association, 21(11), 1609-1616. https://doi.org/10.1016/j.jamda.2020.05.009

Jika, B. M., Khan, H. T., & Lawal, M. (2021). Exploring experiences of family caregivers for older adults with chronic illness: a scoping review. Geriatric Nursing, 42(6), 1525-1532. https://doi.org/10.1016/j.gerinurse.2021.10.010

Kalánková, D., Stolt, M., Scott, P. A., Papastavrou, E., Suhonen, R., & RANCARE COST Action CA15208. (2021). Unmet care needs of older people: A scoping review. Nursing Ethics, 28(2), 149-178. https://doi.org/10.1177/0969733020948112

Khadijah Alavi & Fazni Mat Arifin. (2022). Rumahku Syurgaku: Penjagaan Warga Emas Jangka Masa Panjang Di Malaysia. Penerbit Universiti Kebangsaan Malaysia.

Lekan, D. A., Collins, S. K., & Hayajneh, A. A. (2021). Definitions of frailty in qualitative research: A qualitative systematic review. Journal of Aging Research, 2021, 1–20. https://doi.org/10.1155/2021/ 6285058

Mansfield, E., Cameron, E. C., Boyes, A. W., Carey, M. L., Nair, B., Hall, A. E., & Sanson-Fisher, R. W. (2022). Prevalence and type of unmet needs experienced by carers of people living with dementia. Aging & Mental Health, 1-7. https://doi.org/10.1080/13607863.2022.2053833

Nassuruddin, A. S. M. (2021). Pembiayaan nafkah ibu bapa: Kajian pelaksanaan di Pasir Mas Kelantan. RABBANICA-Journal of Revealed Knowledge, 2(2), 97-112.

Nurhayati Mohamad, Khadijah Alavi, Mohd Suhaimi Mohamad, Nur Saadah Mohamad Aun. (2017). pengalaman sokongan sosial intergenerasi dalam kalangan warga emas di Institusi Kebajikan Awam. Akademika, 87(1), 65-74.

Rasiah, J., Gruneir, A., Oelke, N. D., Estabrooks, C., Holroyd-Leduc, J., & Cummings, G. G. (2022). Instruments to assess frailty in community dwelling older adults: A systematic review. International Journal of Nursing Studies, 134, 104316. https://doi.org/10.1016/j.ijnurstu.2022.104316

Saadah, N. M., & Abdullah, H. (2015). Strategi daya tindak dan program sokongan sosial untuk penjaga tidak formal. e-BANGI:Journal of Social Sciences & Humanities, 10(1), 170.

Sieber, C. C. (2017). Frailty – From concept to clinical practice. Experimental Gerontology, 87(Pt B), 160– 167. https://doi.org/10. 1016/j.exger.2016.05.004

Søvde, B. E., Sandvoll, A. M., Natvik, E., & Drageset, J. (2024). Caregiving for frail home‐dwelling older people: A qualitative study of family caregivers' experiences. International Journal of Older People Nursing, 19(1), e12586. https://doi.org/10.1111/opn.12586

Stein, J., Luppa, M., König, H. H., & Riedel-Heller, S. G. (2014). Assessing met and unmet needs in the oldest-old and psychometric properties of the German version of the Camberwell Assessment of Need for the Elderly (CANE)–a pilot study. International psychogeriatrics, 26(2), 285-295. https://doi.org/10.1017/S1041610213001993

Tamat, A., & Vellymalay, S. K. N. (2019). Warga emas dan pilihan penempatan di Pusat Jagaan Harian. e- BANGI: Journal of Social Sciences & Humanities,16, 1-22.

Tsai, C. F., Hwang, W. S., Lee, J. J., Wang, W. F., Huang, L. C., Huang, L. K., ... & Fuh, J. L. (2021). Predictors of caregiver burden in aged caregivers of demented older patients. BMC geriatrics, 21, 1- 9. https://doi.org/10.1186/s12877-021-02007-1

Vlachantoni, A., Evandrou, M., Falkingham, J., & Qin, M. (2024). Dynamics of unmet need for social care in England. Ageing & Society, 44(6), 1247-1265. https://doi.org/10.1017/S0144686X22000745

Walston, J., Hadley, E. C., Ferrucci, L., Guralnik, J. M., Newman, A. B., Studenski, S. A., ... & Fried, L. P. (2006). Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. Journal of the American Geriatrics Society, 54(6), 991-1001.

Weaver, R. H. (2017). Service Use and Health Outcomes of Low Income Older Adults with Unmet Needs. (Doctoral dissertation, Virginia Polytechnic Institute and State University).

World Health Organization. (2017). WHO clinical consortium on healthy ageing: topic focus: frailty and intrinsic capacity: report of consortium meeting, 1–2 December 2016 in Geneva, Switzerland (No. WHO/FWC/ALC/17.2). World Health Organization.

Xiao, C., Patrician, P. A., Montgomery, A. P., Wang, Y., Jablonski, R., & Markaki, A. (2024). Filial piety and older adult caregiving among Chinese and Chinese-American families in the United States: a concept analysis. BMC nursing, 23(1), 115. https://doi.org/10.1186/s12912-024-01789-0

Zhao, J., Liu, Y. W. J., Tyrovolas, S., & Mutz, J. (2023). Exploring the concept of psychological frailty in older adults: a systematic scoping review. Journal of Clinical Epidemiology. 159, 300-308. https://doi.org/10.1016/j.jclinepi.2023.05.005