Exploring the Factors Associated with IADL Disability Among Elderly in Kelantan, Malaysia: Qualitative Findings from a Mixed-Method Study

Abstract

Background/Purpose: Aging is associated with disability due to chronic disease and aging itself as a process. Instrumental activities of daily living (IADL) is a construct which describes the functional ability to perform complex activities, requiring physical and mental capability thus allowing an elderly to live independently. This qualitative study, using phenomenological approach, is part of a mixed method study to explain factors associated with IADL disability among elderly attending health clinics in Kelantan. Methods: Approximately 248 elderly persons were recruited and 16 of those were purposively selected for in-depth interviews. All participants had IADL disabled status, measured by Lawton IADL Scale. A semi-structured interview was developed based on the quantitative findings. The interviews were transcribed per verbatim, and the data were analysed using thematic analysis. Results: Four themes emerged from this study; age-related problems, social support, poor educational attainment, and financial challenges. Age-related problems included accumulation of comorbidities, frailty and fatigue as well as low motivation. Social support referred to loss of dependency after spouse death and filial piety. Poor educational attainment influenced IADL disability through poor literacy and barrier in communication. Financial challenges affected IADL disability through lack of health care needs. Conclusion: This study findings underlined the need to improve strategies in promoting health and wellbeing to our elderly. Policies should aim to reduce the burden of complication of chronic diseases. An equitable universal social protection policy should be available for all elderly.