Philosophiae Doctor - PhD / The purpose of the study was to explore the needs, problems and living experiences of the older persons in Uganda and their implications for decision making and policy. The study was an exploratory descriptive cross-sectional study that involved triangulation of both qualitative and quantitative approaches. It was guided by five objectives, which included: exploring the living experiences of Uganda' s older persons living in both rural and urban settings; identifying the barriers to these people's effective participation in society; establishing the mechanisms that they use to cope with the barriers; evaluating the extent to which their needs are addressed by policy; and proposing policy strategies needed to address their plight. The study sample consisted of two purposively selected sub samples of 165 older persons for qualitative data and 50 key informants for quantitative data. The key informants were selected from Ministries of Gender, Labour and Social Development; Urban, Housing and Physical Planning; Agriculture; Health; Education and Sports, Public service, and nongovernmental organizations dealing with the older persons in Uganda. Data were collected using in depth interviews with older persons, self administered questionnaire to key informants and documentary review. The qualitative data was analyzed using content analysis including documentary review, while the quantitative data was analysed using the frequency option of the descriptive method of SPSS, and graphical method of the Excel programme. Results show that the living experiences of most of Uganda's older persons are characterised by pathetic economic, health, social, housing and accommodation, water supply, and sanitation conditions. The barriers to the effective participation of these people in society take the form of age-related prejudices, problems, and limitations faced at personal, household and community levels. They basically include constraints to the physical fitness, healthcare, economic status, food security and nutrition, and realization of accommodation and housing conditions desired by these people to live a life by which they can effectively participate in society. Other barriers include: large numbers of grandchildren most of whom are orphans left behind by the older person's children claimed by the HIV/AIDS pandemic and community members ignoring them as helpless people who have outlived their usefulness. Accordingly, the coping mechanisms used by these people were established as the psychological, physical, healthcare, and economic ways by which they deal with each of the aforementioned barriers. A review of development policies such as PEAP, PMA, NAADS, HIV/AIDS policies among others revealed that a number of policies and programs in Uganda exclude the older persons from active participation. Findings show further that though the extent to which the Constitution of Uganda government recognizes the plight of the older persons is appreciable, it is largely insufficiently translated into policy action by which the plight can be effectively addressed. A number of strategies were therefore proposed to help address this insufficiency, thereby solving the needs and attending to the barriers facing these people in an effective policy manner. The strategies focused on improving older persons' physical fitness, access to healthcare, economic capacity, food security and nutrition, and housing and accommodation. Other strategies focused on dealing with the impacts of HIV/AIDS and community prejudices held against older persons. The study was concluded by observing that although the quality of the living experiences of Uganda's older persons can be improved by dealing with the barriers faced by these people, the mechanisms that they use to do so are not adequate. It was also noted that there was need to translate the constitutionally recognised plight of the older persons into effective policy action. Consequently, it was recommended that the proposed policy strategies should be adopted and translated into the needed policy action. Further research was also recommended into the legal implications and funding implications of the proposed policy strategies.

Bakgrund: Den äldre befolkningen ökar i rask takt och bor i större utsträckning hemma längre. Människan är beroende av gemenskap och de äldre är en utsatt grupp som löper större risk att drabbas av ensamhet. Ensamhet kan idag ses som en folksjukdom och kan bidra till flertalet somatiska sjukdomar, psykisk ohälsa och en känsla av utanförskap. Syfte: Syftet med denna kvalitativa litteraturstudie var att beskriva äldres erfarenheter av ofrivillig ensamhet. Metod: En kvalitativ artikelöversikt har tillämpats för att genomföra denna litteraturstudie. Sökningar genomfördes i tre olika databaser och artiklar valdes utifrån inklusions- och exklusionskriterier samt efter genomgången kvalitetsgranskning. Nio kvalitativa studier som svarade mot studiens syfte valdes ut, analyserades och sammanställdes till ett resultat. Resultat: I resultatsammanställningen identifierades tre huvudkategorier och åtta subkategorier. Huvudkategorierna var: Orsaker till ensamhet, konsekvenser av ensamhet och faktorer som lindrar ensamhet. Konklusion: Ensamhet är komplext och en högst individuell upplevelse. Många äldre upplever ensamhet som något plågsamt och ett hinder som skapar en barriär mellan dem och den sociala världen. En åldrande kropp och förlust av relationer samt en känsla av utanförskap var vanligt förekommande teman i samtliga valda studier. Sjuksköterskan kan med enkla medel eventuellt lindra lidande, förebygga ohälsa och stärka de äldres känsla av sammanhang. / Background: The elderly population is increasing rapidly and are living at home longer. The human being is dependent on solidarity and the elderly are a vulnerable group who are at greater risk of suffering from loneliness. Loneliness can today be seen as an public health disease and can contribute to a lot of different somatic diseases, mental illnes and a feeling of exclusion. Aim: The aim of this qualitative literature study was to describe older persons experiences of involuntary loneliness. Methods: A qualitative article review has been applied to this litteraturestudy. The search was conducted in three different databases and the articles were selected based on the inclusion- and exclusioncriteria and a quality review. Nine qualitative studies that answered to the authors purpose were selected, analyzed and compiled into a result. Results: In the compilation of the results, three different main categories and eight subcategories emerged. The main categories were: Causes of loneliness, experiences of loneliness and factors the alleviate loneliness. Conclusion: Loneliness is a complex and highly individual experience. Many older persons experience loneliness as something painful, and an obstacle that created a barrier between them and the social world. An aging body and loss of relationships as well as a feeling of exclusion were common themes in all selected studies. The reg. nurse can with simple means possible alleviate suffering, prevent ill health and strengthen the elderly’s sense of coherence.

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Despite the growing numbers and valuable contributions of older individuals to society, they continue to face negative attitudes towards them. Such attitudes are largely influenced by portrayal of older persons in the media. Understanding how the media portrays older people to the public can provide significant insights into the nature of the images from which older people may make comparisons and which inform the perceptions, opinions, and attitudes of other people. There is little knowledge of perceptions of media portrayal in old age, and this study aimed to obtain insight from the point of view of older people regarding how they are portrayed in the printed media. Qualitative research has been applied to gain insight in the older persons’ perceptions. The case study method was chosen since it allowed the researcher to gain an in–depth understanding of older person’s perceptions regarding how they are portrayed in the media. The participants in this study consisted of nine male and 12 female individuals residing in a residential care facility. Persons between the ages of 60 and 85 were purposively chosen since they can contribute to meaningful insight regarding how they are portrayed in the print media. Data was collected by means of conducting focus group discussions and individual interviews. The use of these methods enabled dynamic interactions resulting in the production of rich, detailed information. Data was analyzed using thematic content analysis and key–word–in–context analysis. Guidelines to ensure the integrity of the findings have been applied. The findings indicated that older persons perceive their portrayal in the media to be minimal in terms of the exposure that they receive. Older persons feel that on the seldom occasion when they are in the media, they are presented as an isolated population separated from younger persons. The portrayal of older persons in the media is also perceived as stereotypical in the sense that older persons are presented as sick, inactive, weak and fragile. The implications of such portrayal according to older persons are that they influence intergenerational relationships and they also confirm stereotypical assumptions about older persons. Older persons feel that they rather want to be portrayed in terms of the valuable contributions that they are making to all spheres of life, despite old age. The media should thus promote positive ageing, which could contribute to the stimulation and motivation of older persons. Findings of this study also indicate that while older persons enjoy reading magazines and newspapers they are often limited to do so due to financial restrictions and physical limitations such as poor eyesight. The findings of this research of older persons perceptions regarding their portrayal in the media has implications for intergenerational relationships as well as to advertisers and marketers who are looking to appeal to the older population. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.

Despite the growing numbers and valuable contributions of older individuals to society, they continue to face negative attitudes towards them. Such attitudes are largely influenced by portrayal of older persons in the media. Understanding how the media portrays older people to the public can provide significant insights into the nature of the images from which older people may make comparisons and which inform the perceptions, opinions, and attitudes of other people. There is little knowledge of perceptions of media portrayal in old age, and this study aimed to obtain insight from the point of view of older people regarding how they are portrayed in the printed media. Qualitative research has been applied to gain insight in the older persons’ perceptions. The case study method was chosen since it allowed the researcher to gain an in–depth understanding of older person’s perceptions regarding how they are portrayed in the media. The participants in this study consisted of nine male and 12 female individuals residing in a residential care facility. Persons between the ages of 60 and 85 were purposively chosen since they can contribute to meaningful insight regarding how they are portrayed in the print media. Data was collected by means of conducting focus group discussions and individual interviews. The use of these methods enabled dynamic interactions resulting in the production of rich, detailed information. Data was analyzed using thematic content analysis and key–word–in–context analysis. Guidelines to ensure the integrity of the findings have been applied. The findings indicated that older persons perceive their portrayal in the media to be minimal in terms of the exposure that they receive. Older persons feel that on the seldom occasion when they are in the media, they are presented as an isolated population separated from younger persons. The portrayal of older persons in the media is also perceived as stereotypical in the sense that older persons are presented as sick, inactive, weak and fragile. The implications of such portrayal according to older persons are that they influence intergenerational relationships and they also confirm stereotypical assumptions about older persons. Older persons feel that they rather want to be portrayed in terms of the valuable contributions that they are making to all spheres of life, despite old age. The media should thus promote positive ageing, which could contribute to the stimulation and motivation of older persons. Findings of this study also indicate that while older persons enjoy reading magazines and newspapers they are often limited to do so due to financial restrictions and physical limitations such as poor eyesight. The findings of this research of older persons perceptions regarding their portrayal in the media has implications for intergenerational relationships as well as to advertisers and marketers who are looking to appeal to the older population. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.

The population of older persons has increased dramatically over the years in South Africa as well as internationally. As populations continue to age, the concept of active ageing has received increasing attention from researchers. Active ageing can be defined as the process of optimising older persons’ opportunities for health promotion, participation, and security in order to enhance their quality of life. In this definition, “health” refers to physical, mental, and social well-being. “Participation” refers to the optimisation of participation in activities such as employment, education, the arts, and religion, and “security” refers to ways in which the protection, dignity, and care of older persons can be maintained and improved. The distribution of older persons in South Africa by ethnic group is disproportionate with older white persons representing 21% of the total older population. Many of these white older persons reside in retirement villages resulting in their being populated by older white persons more so than by members of other ethnic groups. Retirement village policies and programmes generally incorporate an active ageing philosophy. However, most research on active ageing in retirement villages is conducted internationally, and, furthermore, it does not include the subjective experiences of older persons in these active environments. The aim of this research was therefore to explore the experiences of older residents in a retirement village with an active ageing approach. Barker’s behaviour setting theory and the continuity theory were applied in this study. The behaviour setting theory holds that the environment (retirement village) in which people function is important when explaining human behaviour and exploring the subjective experiences of older persons. The continuity theory rests on the premise that ageing is not a static process but rather an ongoing process and that continuity is a primary strategy used by people to deal with changes associated with ageing. According to this theory, people endeavour to continue with the psychological and social patterns they developed and adopted during their lifetimes. The study was conducted at a retirement village in Boksburg, Johannesburg (Gauteng, South Africa), that follows an active ageing approach, making it an ideal context for exploring the subjective experiences of older persons in an active ageing environment. The retirement village has a dedicated life style consultant who has developed specific programmes for every day of the week with time slots allocated for different activities in which older persons can participate. The programmes exclude frail people in the facility who cannot participate owing to their physical limitations. The director of the organisation that is responsible for many retirement villages, and this one in particular, contacted the researchers and asked them to explore the residents’ quality of life experiences so that the services provided to them could be adjusted if necessary. Ethical approval for the research was obtained from the Health Research Ethics Committee of the North-West University. The manager of the retirement village was also asked to distribute posters indicating the nature of the research. On the day of the data gathering, the participants were told about the research and that they would be required, if they wished to participate, to engage in individual interviews with the researchers and take part in the Mmogo-method®, a projective visual research method (Roos, 2008, 2012). The residents who agreed to participate gave their informed consent and confirmed that their participation was voluntary and they had been made aware that they could withdraw from the study at any time. Twenty participants were recruited for the study of whom 16 were women and four were men. The ages ranged between 65 and 80 years with an average age of 73. Two of the participants were English speaking, and the remainder were Afrikaans speaking. They were given the Mmogo-method® materials, which consisted of clay, straws, and colourful beads, and were invited to make visual representations of their lives and activities at the retirement village. The research request was, “Build something that describes your life here at the retirement village”. When all the participants had completed their visual representations, the representations were photographed and served as visual data. The researcher then asked each participant what he or she each had made and why he or she had made it. An informal group discussion was subsequently held with the 18 participants who had taken part in the Mmogo-method®. Individual in-depth interviews with two participants were conducted after the Mmogo-method® had been carried out. All the discussions were audiotaped and served as textual data. The visual data were analysed by getting the literal meanings of the visual representations from the participants in relation to the specific research request. The textual data were analysed thematically, which involved identifying, analysing, and reporting patterns or themes in the data. Different techniques, including crystallisation and member checking, were applied to ensure the trustworthiness of the research process and findings. The findings revealed that the participants were actively involved in a variety of activities on a daily basis. The activities included physical activities organised by the life style consultant or self-initiated activities such as playing tennis, doing line-dancing, going for brisk walks, working out in the gymnasium, and engaging in recreational activities such as fishing, reading, and scrapbooking. The objectives of these activities were to maintain joint flexibility, general health, and mental fitness. Some of the older residents had formalised roles in the retirement village, which they had previous experience of. The participants also took part in different social activities such as paying social visits and making friends. The spiritual activities of the participants were solitary as well as communal. The participants thus experienced the retirement village as a very busy environment with full schedules. In such an environment, people often engage in activities to distract themselves from dealing with difficult circumstances in their lives. Barker’s settings theory holds that older residents’ physical presence in an active environment influences their levels of activity and their subjective experiences. For some residents, an active environment fits into the continuation of the active life styles they developed during the course of their lives, but for others it may have implications for their psychological well-being if they do not have self-regulatory skills to navigate themselves and act merely on feeling obligated to do something. Using an active environment to deal with difficult circumstances can be either a constructive or a destructive coping strategy for older persons. The individual needs of residents should always be taken into account, and retirement villages with an active ageing approach should be aware that one size does not fit all. This study aimed to draw the attention of retirement village managers to the need to take cognisance of the experiences of older persons when implementing ageing policies in their facilities. It also shed new light on the experiences of active ageing among older residents. / MA (Clinical Psychology), North-West University, Potchefstroom Campus, 2015

The focus of this study is on the evaluation of community based care and support service for older persons in the community. The government of South Africa and other African Countries held several discussions with the intention of addressing the needs and challenges of older persons in the community. As a follow up to the discussion, the new developmental approach, that is the South African Policy for Older Persons of 2005 and the Older Persons Act, 13 of 2006, promulgated in line with the recommendation of the Madrid International Plan of Action on ageing which was drafted and adopted at the World Assembly on Ageing that was convened by the United Nations in 2002. Older Persons Act 13 of 2006 was developed with the intention of addressing the needs of older persons in the community as the Aged Act no 100 of 1967 as amended in 1998, was focusing more on the residential care service. The Older Persons Act 13 of 2006 recognizes the importance of community-based care and support services and this means that the service delivery to older persons has been broadened and services have become more inclusive and accessible. Older persons will be able to remain in their communities within their families for as long as possible. According to the Older Persons Act 13 of 2006, the community-based care and support services means any programmes that are rendered to older persons to enable them to remain independent in their communities for as long as possible. These programmes are preventing the unnecessary admission of older persons in the residential care facilities. According to the Older Persons Act 13 of 2006, the Community-based care and support services are categorized into, namely, prevention and promotion programmes and the home-based care services. These two categories will be discussed in details in this study. In this study the researcher used the older persons (recipients of services), representatives of management committees for the Non-profit organizations rendering services to older persons in the community and the officials of the Department of Social Development as participants. The aim of this study is to discuss and evaluate the community-based care and support services strategy as used by the Department of Social Development in rendering services to older persons within communities in Motheo District (Free State Province) and to raise the viewpoints of direct service providers (management committees) officials of the Department of Social Development and older persons that receive these services, in order to enhance the delivery of this programme. The research methodology that was utilized in this study includes the empirical research and the literature review. A literature review was conducted by the researcher for a clear understanding of the nature and meaning of the problem that has been identified. The questionnaires and interview tools were used by the researcher as methods of data collection. This study consists of two articles, article 1: Background and nature of community-based care and support services and article 2: Evaluation of community-based care and support services The findings from the study indicated that the community based care and support services can be the best and important programme for older persons in the community if it can be well implemented. / MSW, North-West University, Potchefstroom Campus, 2014

The population of older persons has increased dramatically over the years in South Africa as well as internationally. As populations continue to age, the concept of active ageing has received increasing attention from researchers. Active ageing can be defined as the process of optimising older persons’ opportunities for health promotion, participation, and security in order to enhance their quality of life. In this definition, “health” refers to physical, mental, and social well-being. “Participation” refers to the optimisation of participation in activities such as employment, education, the arts, and religion, and “security” refers to ways in which the protection, dignity, and care of older persons can be maintained and improved. The distribution of older persons in South Africa by ethnic group is disproportionate with older white persons representing 21% of the total older population. Many of these white older persons reside in retirement villages resulting in their being populated by older white persons more so than by members of other ethnic groups. Retirement village policies and programmes generally incorporate an active ageing philosophy. However, most research on active ageing in retirement villages is conducted internationally, and, furthermore, it does not include the subjective experiences of older persons in these active environments. The aim of this research was therefore to explore the experiences of older residents in a retirement village with an active ageing approach. Barker’s behaviour setting theory and the continuity theory were applied in this study. The behaviour setting theory holds that the environment (retirement village) in which people function is important when explaining human behaviour and exploring the subjective experiences of older persons. The continuity theory rests on the premise that ageing is not a static process but rather an ongoing process and that continuity is a primary strategy used by people to deal with changes associated with ageing. According to this theory, people endeavour to continue with the psychological and social patterns they developed and adopted during their lifetimes. The study was conducted at a retirement village in Boksburg, Johannesburg (Gauteng, South Africa), that follows an active ageing approach, making it an ideal context for exploring the subjective experiences of older persons in an active ageing environment. The retirement village has a dedicated life style consultant who has developed specific programmes for every day of the week with time slots allocated for different activities in which older persons can participate. The programmes exclude frail people in the facility who cannot participate owing to their physical limitations. The director of the organisation that is responsible for many retirement villages, and this one in particular, contacted the researchers and asked them to explore the residents’ quality of life experiences so that the services provided to them could be adjusted if necessary. Ethical approval for the research was obtained from the Health Research Ethics Committee of the North-West University. The manager of the retirement village was also asked to distribute posters indicating the nature of the research. On the day of the data gathering, the participants were told about the research and that they would be required, if they wished to participate, to engage in individual interviews with the researchers and take part in the Mmogo-method®, a projective visual research method (Roos, 2008, 2012). The residents who agreed to participate gave their informed consent and confirmed that their participation was voluntary and they had been made aware that they could withdraw from the study at any time. Twenty participants were recruited for the study of whom 16 were women and four were men. The ages ranged between 65 and 80 years with an average age of 73. Two of the participants were English speaking, and the remainder were Afrikaans speaking. They were given the Mmogo-method® materials, which consisted of clay, straws, and colourful beads, and were invited to make visual representations of their lives and activities at the retirement village. The research request was, “Build something that describes your life here at the retirement village”. When all the participants had completed their visual representations, the representations were photographed and served as visual data. The researcher then asked each participant what he or she each had made and why he or she had made it. An informal group discussion was subsequently held with the 18 participants who had taken part in the Mmogo-method®. Individual in-depth interviews with two participants were conducted after the Mmogo-method® had been carried out. All the discussions were audiotaped and served as textual data. The visual data were analysed by getting the literal meanings of the visual representations from the participants in relation to the specific research request. The textual data were analysed thematically, which involved identifying, analysing, and reporting patterns or themes in the data. Different techniques, including crystallisation and member checking, were applied to ensure the trustworthiness of the research process and findings. The findings revealed that the participants were actively involved in a variety of activities on a daily basis. The activities included physical activities organised by the life style consultant or self-initiated activities such as playing tennis, doing line-dancing, going for brisk walks, working out in the gymnasium, and engaging in recreational activities such as fishing, reading, and scrapbooking. The objectives of these activities were to maintain joint flexibility, general health, and mental fitness. Some of the older residents had formalised roles in the retirement village, which they had previous experience of. The participants also took part in different social activities such as paying social visits and making friends. The spiritual activities of the participants were solitary as well as communal. The participants thus experienced the retirement village as a very busy environment with full schedules. In such an environment, people often engage in activities to distract themselves from dealing with difficult circumstances in their lives. Barker’s settings theory holds that older residents’ physical presence in an active environment influences their levels of activity and their subjective experiences. For some residents, an active environment fits into the continuation of the active life styles they developed during the course of their lives, but for others it may have implications for their psychological well-being if they do not have self-regulatory skills to navigate themselves and act merely on feeling obligated to do something. Using an active environment to deal with difficult circumstances can be either a constructive or a destructive coping strategy for older persons. The individual needs of residents should always be taken into account, and retirement villages with an active ageing approach should be aware that one size does not fit all. This study aimed to draw the attention of retirement village managers to the need to take cognisance of the experiences of older persons when implementing ageing policies in their facilities. It also shed new light on the experiences of active ageing among older residents. / MA (Clinical Psychology), North-West University, Potchefstroom Campus, 2015

The focus of this study is on the evaluation of community based care and support service for older persons in the community. The government of South Africa and other African Countries held several discussions with the intention of addressing the needs and challenges of older persons in the community. As a follow up to the discussion, the new developmental approach, that is the South African Policy for Older Persons of 2005 and the Older Persons Act, 13 of 2006, promulgated in line with the recommendation of the Madrid International Plan of Action on ageing which was drafted and adopted at the World Assembly on Ageing that was convened by the United Nations in 2002. Older Persons Act 13 of 2006 was developed with the intention of addressing the needs of older persons in the community as the Aged Act no 100 of 1967 as amended in 1998, was focusing more on the residential care service. The Older Persons Act 13 of 2006 recognizes the importance of community-based care and support services and this means that the service delivery to older persons has been broadened and services have become more inclusive and accessible. Older persons will be able to remain in their communities within their families for as long as possible. According to the Older Persons Act 13 of 2006, the community-based care and support services means any programmes that are rendered to older persons to enable them to remain independent in their communities for as long as possible. These programmes are preventing the unnecessary admission of older persons in the residential care facilities. According to the Older Persons Act 13 of 2006, the Community-based care and support services are categorized into, namely, prevention and promotion programmes and the home-based care services. These two categories will be discussed in details in this study. In this study the researcher used the older persons (recipients of services), representatives of management committees for the Non-profit organizations rendering services to older persons in the community and the officials of the Department of Social Development as participants. The aim of this study is to discuss and evaluate the community-based care and support services strategy as used by the Department of Social Development in rendering services to older persons within communities in Motheo District (Free State Province) and to raise the viewpoints of direct service providers (management committees) officials of the Department of Social Development and older persons that receive these services, in order to enhance the delivery of this programme. The research methodology that was utilized in this study includes the empirical research and the literature review. A literature review was conducted by the researcher for a clear understanding of the nature and meaning of the problem that has been identified. The questionnaires and interview tools were used by the researcher as methods of data collection. This study consists of two articles, article 1: Background and nature of community-based care and support services and article 2: Evaluation of community-based care and support services The findings from the study indicated that the community based care and support services can be the best and important programme for older persons in the community if it can be well implemented. / MSW, North-West University, Potchefstroom Campus, 2014