Perceived neighborhood social cohesion and functional disability among older adults: The moderating roles of sex, physical activity, and multi-morbidity.

Though the Ghanaian social structure is largely communal in several of its social life and social spaces, the extent to which cohesive neighbourhood affects functional ability of older persons and the moderating factors of the relationship, are unknown in Ghana. This study examines the moderating roles of sex, multimorbidity, and physical activity on the association between neighbourhood social cohesion and functional disability among older people in Ghana. A cross-sectional study of 4,446 people-50 years and older-from WHO's Study on global AGEing and adult health Ghana Wave 2 was employed. Functional disability-WHO Disability Assessment Schedule 2.0-and neighbourhood social cohesion measured with community-level participation, perceived trust and safety were studied. Generalised Logistic regressions with interactional tests were used to examine the associations. A more socially cohesive neighbourhood was significantly associated with a lower functional disability among older people (OR = 0.94, 95%CI: 0.93, 0.94; P<0.001). A similar relationship was found for community-level participation (aOR = 0.94, 95%CI: 0.94, 0.95; P<0.001) and perceived trust (aOR = 1.00, 95%CI: 0.99, 1.00; P<0.001). Community-level participation is associated with a lower functional disability among older people who were physically active (aOR = 0.98, 95%CI: 0.96, 0.99; P<0.001). Among the three individual-level measures of neighbourhood social cohesion, only physical activity (OR = 0.98, 95%CI: 0.98, 0.99; P<0.01) moderated the association between community-level participation and functional disability. Community-level participation, along with physical activity, may be relevant in improving functional ability among older people. The results highlight the usefulness of policy to ensure a more socially cohesive neighbourhood for older people in Ghana to improve their quality of life.

Prevalence and determinants of care needs among older people in Ghana.

INTRODUCTION: Given the longevity noticed among older people in Ghana, and the potential occurrence of functional disability in later years of life, it has become essential to understand their care needs. This study examined the care needs in daily tasks and associated factors in Ghana, following the World Health Organisation International Classification of Functioning, Disability and Health framework. MATERIALS AND METHODS: A cross-sectional survey was conducted among a sample of 400 older people from Komfo Anokye Teaching Hospital in Southern Ghana. Care need was assessed by one question; "Do you regularly need help with daily tasks because of long-term illness, disability, or frailty?" Multivariate logistic regression was used to test the association between care need and independent variables based on the WHO-ICF conceptual framework. RESULTS: Majority of the sample (81%), particularly women (54%) reported needing care in daily tasks. Per the WHO-ICF conceptual framework, functional disability-activity variable, (OR = 1.07 95%CI: 1.05-1.09, p<0.001), and absence of government support-an environmental factor, (OR = 3.96 95%CI: 1.90-8.25, p<0.001) were associated with care need. CONCLUSIONS: The high prevalence of care needs among older people may offer an indication that majority of older people in Ghana could benefit from long-term care services. Functional disability and the absence of government support are the major issues that need to be prioritised in addressing the increased demand for care related to performing daily tasks among older people in Ghana.

Housing conditions and long-term care needs of older adults in Ghana: Evidence from the WHO SAGE Ghana Wave 1.

The present study examined the association between housing conditions and long-term care needs of older adults in Ghana. We used data from 4,920 adults aged ≥50 years that participated in the World Health Organisation's (WHO) Study on adult health and AGEing Ghana Wave 1. Housing conditions were assessed with drinking water, sanitation, cooking conditions and building materials, and long-term care needs were based on WHO Disability Assessment Schedule 2.0. Multivariable logistic regressions modelled the effect of housing conditions on long-term care needs. After full adjustment for all available potential confounders, older adults living in households with unimproved cooking conditions had higher odds of reporting long-term care needs (OR = 6.87, 95%CI: 5.04-9.37) compared to those in improved cooking condition households. Moreover, those in households with unimproved housing materials (OR = 1.27, 95%CI: 1.01-1.72) and those in unimproved sanitation households (OR = 1.26, 95%CI: 1.05-1.54) were more likely to experience long-term care needs after respectively controlling for demographic and health-related covariates. Poor housing conditions are risk factors of long-term care needs in Ghana. Efforts to improve housing conditions may benefit older age functional abilities and unmet long-term care needs.

The nature and extent of healthcare provision for people with intellectual disabilities in Ghana: A qualitative study.

Ghana has designated special schools with the mandate of training and equipping persons with intellectual disabilities with social functioning and vocational skills needed to promote their social inclusion. This study investigates the nature and extent of healthcare provision for persons with intellectual disabilities in their respective special schools. This research adopted a qualitative, but participatory approach to collect data from respective stakeholders. The findings reveal that some of these special schools do not have professional health workers, and most healthcare providers have challenges diagnosing and prescribing medication for this population due to the health workers' limited understanding of their healthcare needs, coupled with communication barriers. The researchers have suggested setting up of a special health department with personnel who have received training on intellectual disabilities. This department must undertake training for the housemothers in special schools, parents in the communities, and teachers in special schools.

Correlates of older adult inpatients' personal care provision to people with functional difficulties in Ghana.

INTRODUCTION: Most research depicts older adults as needing personal care, with limited research on older adults' contributions in the lives of others in developing countries like Ghana. The purpose of the study was to examine the personal care provision and socio-demographic correlates of personal care provision by older adult inpatients in Ghana. MATERIALS AND METHODS: A hospital-based survey was conducted among 400 consecutively surveyed older adult inpatients at Komfo Anokye Teaching Hospital in southern Ghana. Stata 15 was used to analyse the data. The relationship between personal care and older adult inpatients' socio-demographic characteristics were analysed using the chi-square test. Multivariate logistic regression analysis was employed. RESULTS: Overall, 28% of older adult inpatients provided personal care. Participants were mostly females, married or cohabiting, completed at most junior high school, Christians, urban residents, not working and living with their immediate family. Primarily, most participants provided personal care to one person, once a week, and one-hour duration. Nearly three-quarters of participants provided personal care to someone who lives with them. After adjustment, male older adults were 50% less likely to and urban residents were 83% more likely to provide personal care. Being single, separated or divorced was statistically significantly associated with personal care provision, however, were not statistically significant after adjusting for sex and residence. A post hoc analysis testing for interaction revealed no relationship existing between sex and marital status concerning personal care provision (p = 0.106). CONCLUSION: Female and urban resident older adult inpatients in Ghana are not just passive receivers of care but also provide personal care to others with functional difficulties, independent on age. It further draws attention to the need for policies and programs that can support older adults, particularly females and urban residents, to be productive in the later life.

Attributions of elder neglect: A phenomenological study of older people in Ghana.

The purpose of the study was to explore how neglected older people describe the factors contributing to their state of neglect. A Phenomenological qualitative approach making use of a semi-structured interview was adopted. Purposive criterion and snowballing sampling were employed to recruit 12 older people facing neglect from Winneba in Ghana. Thematic data analysis making use of in-vivo and focussed coding was employed. Four major interrelated themes were identified. The themes are (a) "Since the death of my husband": neglect as a function of a natural cause; (b) "I did not plan well by then": neglect attributed to the self; (c) "They do to all of us": neglect resulting from the failure of government institutions; and, (d) "Our family do not even come to see us": neglect attributed to the breakdown of the extended family system. Application of the ecological theory in the discussion improves our understanding of holistic factors depriving older people of care and protection in Ghana. The findings draw attention to programs and policies, taking into consideration the personal, health and environmental factors to meet the needs of older people in Ghana.