Background: The traditional joint family system in a culturally diverse Pakistani society shows great respect and care for older population by the families and their generations. However, in the recent years the phenomenon of population ageing in Pakistan is rapidly increasing due to demographic shift influencing life expectancy, along with changes in socio-cultural values. This transition has resulted in institutionalization of the elderly as an emerging shelter alternative. The aim of this study was to explore the experiences of the elderly people and to identify the reason which compelled them to reside in these shelter homes. Method: A qualitative methodology, with a descriptive exploratory design, was adopted for the study. A purposive sample of 14 elderly males and females were selected, from two different shelter homes in Karachi, Pakistan. Semistructured interviews were audio recorded and transcribed. Content analysis was done to extract the themes and comprehend the data. Results: Content analysis revealed five major themes: the circumstances of leaving home, experiences, and challenges to wellbeing before entering the care facility, coping with challenges, and decision to live in a shelter home. The analysis discovered that the elderly were experiencing lack of physical, psychological, emotional, and financial support from their family and children. It also indicated that migration of children for better career and employment opportunities, entrance of women into the workforce, and insensitive behaviour of children, left the senior citizens neglected and helpless. The findings also uncovered the challenges of unemployment and family disputes that the elderly had to face made them dependent, distressed, helpless, and lonely resulting in both their apparently willing and forceful decision to reside in shelter homes. Conclusion: The findings point to need for further investigation of the identified areas in this study through qualitative and quantitative researches. There is a dire need for increasing public awareness through the social, electronic, and print media, and providing capacity building training to HCPs for the care of the elderly. The lobbying group can act as a catalyst in persuading the government officials for the execution of a policy on retirement, day care and subsidized provision of health services for the betterment of the elderly.

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AKUSONAM has been a trendsetter for nursing education in Pakistan; including the offering of "Care of Elderly" course to 37 undergraduate nursing students in 2013. It was offered in blended learning format, along with hands on exposure in a variety of geriatric care settings. This study was conducted for course enrollees.Methodology: Through the retrospective descriptive study design, student's Cognitive Engagement (CE) in Online Discussion Forums (ODF) was assessed. Researcher designed demographic tool was used to collect demographic data; while Zhu ( 2006) framework was used to assess CE. Discourse analysis of three ODFs was done for participants who consented to participate. Each group was assigned letter A, B or C for anonymity purpose. Findings:The data revealed wide-ranging CE using the Zhu framework. Majority of the participants in all three groups have used statement type I and II, whereas the higher level of CE was least observed amongst the participants. In group (A) statements type I and II were used by 49.99% of participants; only 20.83% participants demonstrated the use of scaffolding. In group (C) 59.25% of participants used statements type I II, and scaffolding. Group (B) used statement type I significantly (25%). Conclusion:The discourse analysis revealed that CE varied among the three groups. Moreover, higher level of CE such as questioning, mentoring and reflections were the least used in ODFs. This determines the future need to focus on ensuring higher levels of CE amongst course participants.

Abstract Objectives: The growing number of older people due to demographic transition is paving the way for non-governmental organizations and the private sector for mushrooming of old age homes (OAHs). These homes function either free or fee for services, and the services provided at these OAHs determines the quality of life of older people. The aim of the study was to explore the stakeholders’ perception on the quality of services offered to people living in OAHs. Methods: A descriptive qualitative study design was used to explore stakeholders’ perception of elderly living experiences in old age homes. Three OAH were selected through purposive sampling for the study. Data collected from February –March 2015 through the structured interview guide. Participants’ for FGDs were recruited through universal sampling, while purposive sampling was used for KIIs selection. Researcher ensured all ethical considerations for entire study period. Results: Two major themes were drawn including the reasons and experiences of older people living in OAH, secondly the need for caregivers’ academic competencies. Majority of KIIs and FGDs reported common responses under the two themes. Also the elderly experiences varied from living comfortable to being depressed. KIIs and caregivers’ FGD participants’ strongly urged the need for caregivers’ training and institutional accreditation. Conclusion: In conclusion, the older people experiences challenges of living in OAHs, therefore the study findings strongly proposes community support system and credentialing of the caregivers for age appropriate care. Continuous...

Introduction: This paper discusses the perceptions and observations of undergraduate nursing students about elder abuse, observed during their clinical rotation while enrolled in Care of Elderly Course. Elder abuse is an act of harming elder individuals either intentionally or unintentionally.Method: Retrospective descriptive study design was used to analyze the discourse on Online Discussion Forum (ODF) to understand students' perceptions and observations about elder abuse in society. Findings:The discourse analysis revealed the data in three major themes including the causes, types and the prevention of elder abuse. Under the three major themes, participants reported several types of elder abuse including: physical, sexual, emotional, financial exploitation; neglect; abandonment; and self-neglect. These are reported to be due to diverse priorities, brain drain and lack of understanding of the care of elderly people. In consideration to these findings, the suggested strategies included appropriate program planning, caregiver empowerment with knowledge and skill, and government attention in developing laws and Acts to protect the rights of elderly individuals. Conclusion:The study findings clearly highlight the issues that need attention at individual, community and national level to improve quality of life for elderly population in society.