stroke as a critical life event in the

Filipino family
Rene D. Somera , P h. D .
D e L a Salle University
Manila, Philippines

O ld e r

persons

MAP

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

The
Philippines
METRO
MANILA

O ld e r

persons

OBJECTIVES

and their

care
g ivers
OOBBJJEECCTTI IVVEESS

METHODOLOGY

To describe the social and cultural

dimensions of stroke as a critical life
event among a selected group of
older persons and their family
caregivers

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

To gain insights into the patterns of

caregiving for older person stroke
survivors within Filipino families

O ld e r

persons

OBJECTIVES

and their

care
g ivers
OOBBJJEECCTTI IVVEESS

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

To provide an assessment of the

family and community resources
available to older person stroke
survivors and their caregivers, as
well as the nature and extent of
the utilization of these resources

O ld e r

Studys Framework

persons
and their

Community /Family Context

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

C
o
m
m
u
n
I
t
y

STROKE

Older Person

Family Member

Stroke Survivor

Caregiver

Rehabilitation/Recovery

Response to Stroke

COPING

CARING

Resources
Resources

F
a
m
I
l
y

O ld e r

persons

METHODOLOGY

and their

care
g ivers
OBJECTIVES

MMEETTHHOODDOOLLOOGGYY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

The study is descriptive

and exploratory by design.

It utilized both quantitative

and qualitative approaches.
The quantitative component
consisted of a survey while
the qualitative component
consisted of case studies.

O ld e r

persons

METHODOLOGY

and their

care
g ivers
OBJECTIVES

The sample population

consisted of 100 stroke
survivor-caregiver dyads.

MMEETTHHOODDOOLLOOGGYY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

The stroke survivors were

aged 50 years old and above and
had at least one stroke incident
in the past year.

O ld e r

persons

METHODOLOGY

and their

care
g ivers
OBJECTIVES

The respondents names were

obtained through:

LIMITATIONS

discharge records of six DOHretained hospitals, each having at

least 100-bed capacity, a
rehabilitation unit and serving a
wide geographical area

RESULTS

referrals from hospital personnel

SUMMARY OF
RESULTS

snowballing \ referrals from

the respondents

MMEETTHHOODDOOLLOOGGYY

R E C O M
MENDATION

O ld e r

persons

METHODOLOGY

and their

care
g ivers
OBJECTIVES

MMEETTHHOODDOOLLOOGGYY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

From the sample, 10 stroke

survivor-caregiver dyads were
chosen as key informants who
underwent a series of in-depth
interviews.
Two questionnaires were used
in the research: a separate
interview schedule for stroke
survivors and caregivers.

O ld e r

persons

METHODOLOGY

and their

care
g ivers

The survey interview was done

in two phases:

OBJECTIVES

MMEETTHHOODDOOLLOOGGYY

First visit - done four weeks after

discharge from the hospital

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Second visit - occurred three

months after the initial visit

O ld e r

persons

METHODOLOGY

and their

care
g ivers
OBJECTIVES

MMEETTHHOODDOOLLOOGGYY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

For each phase, each of the

stroke survivors was made to
answer simultaneously with his
or her caregiver, having an
average distance of 5-10 meters
to minimize discrepancy in their
responses. Color-coded
flashcards and rest periods
were provided to stroke
survivors

O ld e r

persons

METHODOLOGY

and their

care
g ivers
OBJECTIVES

MMEETTHHOODDOOLLOOGGYY

The qualitative aspect of the study

consisted of case study analyses
The key informants ( KIs ) were
chosen based on the ff. criteria:

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

verbal ability
mental alertness
uniqueness of case

O ld e r

persons

METHODOLOGY

and their

care
g ivers
OBJECTIVES

MMEETTHHOODDOOLLOOGGYY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Three interview guides were

utilized for the in-depth interviews:
one for the stroke survivor, one
for the caregiver, and one home
and environment guide.
The in-depth interviews were all
recorded on tape, transcribed and
finally written into case studies.

O ld e r

persons

METHODOLOGY

and their

care
g ivers
OBJECTIVES

MMEETTHHOODDOOLLOOGGYY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

In-depth analysis of the stroke

experience was later on
extracted to obtain the
important lessons that can be
learned from the stroke
experience, in terms of coping
a n d caregiving attendant to the
illness.

O ld e r

persons

METHODOLOGICAL LIMITATIONS

and their

care
g ivers

Loss of cases due to:

jincomplete address obtained

OBJECTIVES

METHODOLOGY

LLI M
I MI T
I TAATTI O
I ONNSS

from hospital discharge

records

jdeath of respondent
joutright refusal of the
respondent

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

jchange of address of the

respondent

juncontrollable factors such

as inclement weather

O ld e r

persons

METHODOLOGICAL LIMITATIONS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LLI M
I MI T
I TAATTI O
I ONNSS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

The data collection started with

an initial sample of 223 cases
culled from hospital discharge
records of those who were
confined
due
to
stroke\
cerebrovascular accident in six
DOH-retained hospitals. Five
stroke survivor-caregiver dyads
were utilized for pre-testing the
questionnaires.

O ld e r

persons

METHODOLOGICAL LIMITATIONS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LLI M
I MI T
I TAATTI O
I ONNSS

Before the first visit:1 2 3 c a s e s w e r e

lost

Z deceased.. 36
Z outright refusal 13
Z c h a n g e o f A d d r e s s . 15
Z house was not located.. 4 3
Z failed to contact SS/CG 1 6

RESULTS

*Total number of cases during

SUMMARY OF
RESULTS

the 1st visit: 1 0 0 stroke

R E C O M
MENDATION

survivor-caregiver dyads

O ld e r

persons

METHODOLOGICAL LIMITATIONS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

Before the second visit: 1 0

cases were lost
Z deceased 4
Z outright refusal. 3
Z change of address\
left city.. 3

LLI M
I MI T
I TAATTI O
I ONNSS

*Total number of cases during the

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

2nd visit: 9 0 stroke

survivor-caregiver dyads

O ld e r

persons

Some selected informants

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Aling Tinay, 81 and Mang Pedring, 63

O ld e r

persons

Some selected informants

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Mang Baldo , 67 and Ester, 27

O ld e r

persons

Some selected informants

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Mang Jose, 54 and Aling Desa , 57

O ld e r

persons

Some selected informants

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Mang Inggo , 84 and Aling Lily,42

O ld e r

persons

Some selected informants

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Mara , 27 and Mang Tonio , 64

O ld e r

persons

RESULTS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

Profile of SS Respondents
80-85

75-79

70-74

65-69

Female

Male

3
3
6

11
8

60-64

13

RREESSUULLTTSS
11
11

55-59

SUMMARY OF
RESULTS
R E C O M
MENDATION

50-54

6
15

O ld e r

RESULTS

persons
and their

care
g ivers

Civil Status of SS Respondents

OBJECTIVES

METHODOLOGY

0
15

Female

24
1

SUMMARY OF
RESULTS
R E C O M
MENDATION

Widowed
Married

LIMITATIONS

Single

RREESSUULLTTSS

Separated

Male

50
1

O ld e r

RESULTS

persons
and their

care
g ivers

Educational Attainment of SS
60
50

OBJECTIVES

40

25

30
20

12
26

10
0

ry

Male

ge
e

at
na

du

tio

ra
-G
Po

R E C O M
MENDATION

lle
Co

Sc
gh

st

Female

Hi

SUMMARY OF
RESULTS

ho

en
em
El

RREESSUULLTTSS

ol

ta

11

ca

LIMITATIONS

21

Vo

METHODOLOGY

O ld e r

RESULTS

persons
and their

care
g ivers
OBJECTIVES

Number of Stroke Incidents

experienced by SS
70
60

METHODOLOGY

LIMITATIONS

58

50

First Stroke
Second Stroke

40

Third Stroke
Fourth Stroke

30

RREESSUULLTTSS
SUMMARY OF
RESULTS

20
10
0

R E C O M
MENDATION

17

Fifth Stroke

19

>5 stroke incidents

O ld e r

RESULTS

persons
and their

care
g ivers

Relationship of SS to Caregiver
n=100
Spouse
Daughter
Daughter-in-law
Son
Brother
Sister
Mother
Father
Father-in-law
Other relative
Grandparent
Friend

OBJECTIVES
50
45
45

METHODOLOGY

40
35

LIMITATIONS

30
25
25

RREESSUULLTTSS

20
15
15

SUMMARY OF
RESULTS

10

R E C O M
MENDATION

4
1

O ld e r

RESULTS

persons
and their

care
g ivers

SSs' Perceptions of Financial Situation

80
80
67

OBJECTIVES

70
60

METHODOLOGY
50

LIMITATIONS

40

First Visit
Second Visit

30

23

RREESSUULLTTSS

17
20

SUMMARY OF
RESULTS
R E C O M
MENDATION

10

0
Worse

Better

Remained the
Same

O ld e r

RESULTS

persons
and their

care
g ivers

SSs' Sources of Financial Support

60

OBJECTIVES

53
46

50
38

40

36

First Visit

METHODOLOGY

30

Second Visit

22 21

20

LIMITATIONS

10 8

10

12

11

9
3

3 3

R E C O M
MENDATION

e
nc
ra
su
In

er
th
O

Fr

ge

ie

nc

nd

e
at
el
R

er
th
O

SUMMARY OF
RESULTS

iv

ng
ib
S

gh
D

au

li

te

n
o

e
us
po
S

RREESSUULLTTSS

O ld e r

RESULTS

persons
and their

care
g ivers
OBJECTIVES

SS's Ability to Meet Basic Needs

100
90

94 97

98
83

80

METHODOLOGY

70

7679

72

Food

66

Housing

60

Clothing

50

LIMITATIONS

40

40

30

30

RREESSUULLTTSS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Medical Care

20
10
0
1st Visit
n = 100

2nd Visit
n = 90

Recreation

O ld e r

RESULTS

persons
and their

care
g ivers

SSs' Sources of Social Support

83.30%

90%

OBJECTIVES

80%

74%

78%

70%

METHODOLOGY

60%
50%

LIMITATIONS

37.80%

40%
30%
20%

RREESSUULLTTSS

10%

SUMMARY OF
RESULTS
R E C O M
MENDATION

0%
First Visit

Second Visit

Family

74%

83.30%

Other People

78%

37.80%

O ld e r

RESULTS

persons
and their

care
g ivers
OBJECTIVES

SSs' Perception of Own

Physical Health Status
80
74
First Visit

70

METHODOLOGY

60

Second Visit

58

50

LIMITATIONS

40
30

RREESSUULLTTSS
SUMMARY OF
RESULTS

24
20
10
0

11
4

Poor

R E C O M
MENDATION

13

Fair

Good

Excellent

O ld e r

RESULTS

persons
and their

care
g ivers
OBJECTIVES

Profile of Caregiver Respondents

6

7 0 - 8 60
5

6 5 - 6 90
60-64

METHODOLOGY

10

5 5 - 509
50-54

LIMITATIONS

RREESSUULLTTSS
SUMMARY OF
RESULTS
R E C O M
MENDATION

15

45-49

40-44

35-39

30-34

25-29

5
4

Male

Female

4
9
14

2
3
3

20-24
14-19

2
2

O ld e r

RESULTS

persons
and their

care
g ivers
OBJECTIVES

Civil Status of CG Respondents

80
70

METHODOLOGY

60
62

50
LIMITATIONS

Female

40

Male
30
RREESSUULLTTSS
SUMMARY OF
RESULTS
R E C O M
MENDATION

20

12

10

4
10

Married

Widowed

0
Single

4
1
Separated

O ld e r

RESULTS

persons
and their

care
g ivers
6

OBJECTIVES

METHODOLOGY

Educational Attainment of CG

Elementary

38

11

High School
College Level

LIMITATIONS

College Graduate
Post-Graduate

RREESSUULLTTSS

Vocational

SUMMARY OF
RESULTS
R E C O M
MENDATION

37

O ld e r

RESULTS

persons
and their

care
g ivers
OBJECTIVES

Birth Order of CG Respondents

35

32

30

METHODOLOGY

3
4

25

LIMITATIONS

20

6
7

15

14 14 14

RREESSUULLTTSS

10

SUMMARY OF
RESULTS
R E C O M
MENDATION

6
5
0

10

11
3

3
1

12
13

O ld e r

RESULTS

persons
and their

care
g ivers

Relationship of CG to SS
50

OBJECTIVES

45

43
Spouse

40
METHODOLOGY

35

Daughter
31

Daughter-in-law

30

Son

LIMITATIONS

RREESSUULLTTSS

25

Brother

20

Sister

15
SUMMARY OF
RESULTS

Grandchild

10
5

R E C O M
MENDATION

Mother

12

Friend
2

O ld e r

RESULTS

persons
and their

care
g ivers

SELECTED CAREGIVING SITUATIONS

C O N S I D E R E D A S H A S S L E S B Y C G s , 1st visit
Situation

OBJECTIVES

METHODOLOGY

LIMITATIONS

RREESSUULLTTSS
SUMMARY OF
RESULTS
R E C O M
MENDATION

1. Extra expenses incurred

due to caregiving
2. SSs health declined

48%
44%

3. Supervising SS in doing
39%
things
4. Helping SS in personal care 31%
needs
5. Received no help from
27%
family & friends
Note: computed by giving a score of one for every
situation with entry of very distressing (code 4);
includes caregivers with total score of at least 5 out
of perfect score of 8.

O ld e r

persons
and their

care
g ivers

RESULTS
SELECTED CAREGIVING SITUATIONS
C O N S I D E R E D A S H A S S L E S B Y C G s , 2nd VISIT
Situation

OBJECTIVES

Second Visit

1. SSs health declined

40%

2. SSs unresponsiveness

21%

3. Supervising SS in
doing things
4. Received no help from
family or friends
Extra expenses due to
caregiving
5. SSs confusion

18.9%

METHODOLOGY

LIMITATIONS

RREESSUULLTTSS
SUMMARY OF
RESULTS
R E C O M
MENDATION

14.4%
14.4%
6.7%

Note: computed by giving a score of one for every

situation with entry of very distressing (code 4);
includes caregivers with total score of at least 5 out
of perfect score of 8.

O ld e r

RESULTS

persons
and their

care
g ivers

CAREGIVING SITUATIONS CONSIDERED

AS BURDEN BY CAREGIVERS,
1st & 2nd VISITS
Situation

OBJECTIVES

F irst
Visit

Second
Visit

17%

4.4%

Taking care of SS
when not feeling well
METHODOLOGY

LIMITATIONS

RREESSUULLTTSS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Its hard on me emotionally

5%

0%

It caused my health to get worse

6%

0%

Care costs more than I can afford

38%

11.1%

I have to give him constant attention

37%

3.3%

SS gets confused

25%

5.6%

SS embarrasses me or others

22%

0%

SS lapses into senility

10%

2.2%

SS becomes upset & yells at me

22%

5.6%

Note: computed by giving a score of one for every

situation with entry of great deal(code 4); includes
caregivers with total score of at least 5 out of a
perfect score of 9.

O ld e r

RESULTS

persons
and their

care
g ivers

COMMONLY USED COPING STRATEGIES

EMPLOYED BY CAREGIVERS
First Visit

OBJECTIVES

METHODOLOGY

1. not blaming others

95%

2. hoping that things will get better

94%

3. not taking tensions out on others 93%

Second Visit

LIMITATIONS

1. not blaming others

97.8%

not taking tensions out on others 97.8%

RREESSUULLTTSS
SUMMARY OF
RESULTS
R E C O M
MENDATION

2. not getting mad

95.6%

3. trust in the Lord

93.3%

withdraw from the situation

93.3%

Note: computed by giving a score of one for every

situation where the caregiver can cope well;
includes caregivers with total score of at least 18 out
of a perfect score of 34.

O ld e r

RESULTS

persons
and their

care
g ivers
OBJECTIVES

CAREGIVING HASSLES, CAREGIVING BURDEN

& COPING INDEX AMONG CAREGIVERS,
1st&2nd VISITS

Caregiving
Aspects

First
Visit

Second
Visit

Zvalues

Hassle1

20%

2.2%

4.17**

B u r d e n1

10%

1.1%

2.80**

Coping2

51%

67.8%

-2.45**

METHODOLOGY

LIMITATIONS

RREESSUULLTTSS
SUMMARY OF
RESULTS
R E C O M
MENDATION

Note: 1 - gives no. of caregivers who finds

providing care very distressing
2 - includes caregivers who can cope well

**-p<0.01

O ld e r

RESULTS

persons
and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

Services Availed by SS, First Visit

70

70
Help in personal
care

64 64 62

60
50

Learning arm or leg

exercises

40

Help in dealing with

emotions

52

33
RREESSUULLTTSS

30
20

SUMMARY OF
RESULTS
R E C O M
MENDATION

10
0

Hospital aftercare

Help with
prescriptions
Help with financial
planning

O ld e r

RESULTS

persons
and their

care
g ivers

Services Availed by SS, Second Visit

OBJECTIVES

100
METHODOLOGY

90

R E C O M
MENDATION

Finding/organizing
services SS needs

68.9

Hospital aftercare

42.2

40
30

SUMMARY OF
RESULTS

65.6

60
50

RREESSUULLTTSS

Help in personal
care

81.1

80
70

LIMITATIONS

93.3

20
10
0

Help with
prescriptions
Help with financial
planning

O ld e r

persons

SUMMARY OF RESULTS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SSUUMMMMAARR
Y YO O
FF
RREESSUULLTTSS
R E C O M
MENDATION

SS respondents have low

socio -economic status, are at risk for
various illnesses as well as for social
isolation as a consequence of illness.
There were more male SS respondents
which may be attributed to their
lifestyles.
Majority of the SS have low educational
attainment
which
has
profound
implications on their awareness about
stroke
and
factors
which
may
predispose them to the illness.

O ld e r

persons

SUMMARY OF RESULTS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SSUUMMMMAARR
Y YO O
FF
RREESSUULLTTSS
R E C O M
MENDATION

Majority of the SS experienced

stroke for the first time.
Most of the SS were parents who have
to perform their parental roles even if
they are still on the period of recovery.
Majority of the stroke survivors are
dependent on their families for
financial support.
Most of the SS perceived their
situation to be worse for both the
first and the second visits.

O ld e r

persons

SUMMARY OF RESULTS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

Medical care was not well provided

to the stroke survivors, as perceived
by the S S s, themselves.

Support is more apparent during the

first visit after the stroke occurred.

LIMITATIONS

RESULTS
SSUUMMMMAARR
Y YO O
FF
RREESSUULLTTSS
R E C O M
MENDATION

Support from the family significantly

increased during the second visit;
support from other people considerably
declined.

O ld e r

persons
and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

SUMMARY OF RESULTS
Increase in the number of stroke survivors
who are able to perform instrumental
activities of daily living was significant
and implied an improvement in the
over-all health status of the SS.
The majority of the SS expected additional
support on both visits; the need for
psychosocial and economic support is
more apparent during the first visit.

RESULTS
SSUUMMMMAARR
Y YO O
FF
RREESSUULLTTSS
R E C O M
MENDATION

The caregivers in the study were mostly

females;
mostly
immediate
family
members and were mostly the eldest
children.

O ld e r

persons

SUMMARY OF RESULTS

and their

care
g ivers
OBJECTIVES

The C G s were more highly educated

t h a n t h e S S s ; their level of awareness
about stroke, however, did not differ
much from that of the SSs.

METHODOLOGY

LIMITATIONS

RESULTS
SSUUMMMMAARR
Y YO O
FF
RREESSUULLTTSS
R E C O M
MENDATION

Financial constraints associated with

caregiving w a s w h a t t h e C G s f o u n d
as the most distressing aspect of
caregiving during the first visit.

The decline in the S S s h e a l t h w a s

what the C G s found as the most
distressing by the second visit.

O ld e r

persons

SUMMARY OF RESULTS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

The cost of health care which is more

t h a n w h a t t h e C G s could afford is the
most commonly encountered burden for
both visits.
There was an increase in the number of
C G s who are able to cope well by the
second visit, as revealed by the coping
index.

RESULTS
SSUUMMMMAARR
Y YO O
FF
RREESSUULLTTSS
R E C O M
MENDATION

The nature of health services available in

the community is virtually unknown to
almost all of the respondents.

O ld e r

persons

SUMMARY OF RESULTS

and their

care
g ivers

Community health services are not

availed of by the majority of the
respondents.

OBJECTIVES

METHODOLOGY

LIMITATIONS

Reasons cited for not availing community

health services are inadequacy of
services particularly those that would
address the S S s rehabilitation needs,
lack of equipment and trained personnel.

RESULTS
SSUUMMMMAARR
Y YO O
FF
RREESSUULLTTSS
R E C O M
MENDATION

Information about the existence of

community services and the involvement
of family C G s in community efforts is
virtually non-existent.

O ld e r

persons
and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

RECOMMENDATIONS
Research
More systematic and efficient
record-keeping in government
hospitals
Consistency in patient
profile information
The institution of a
computerized data base
management system in the
Records Division of government
hospitals, as a long range goal

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers
OBJECTIVES

The need for a longitudinal study

that would further investigate the
patterns of post-stroke management
in the home

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

A study over a longer period

of time, preferably from one to
two years after the stroke,
would yield richer insights
into the dynamic processes of
stroke rehabilitation, both
from the perspective of
patients and caregivers.

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers
OBJECTIVES

The use of controlled comparison

in a future study

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

This would clarify whether

there is a significant
difference in perceived
burden between two groups
of users and non-users of
services available in the
community

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers
OBJECTIVES

Replication of the study in the

context of other illnesses that
require long-term care

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

This would generate

comparisons in illness
management within the
Filipino home setting.

O ld e r

persons
and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

RECOMMENDATIONS
Program
The existing programs in the
Department of Healths
Non-Communicable Disease
Control Service (NCDCS) Cardiovascular, Health Care
Program for Older Persons
(HCPOP), and Community-Based
Rehabilitation Program (CBRP)
must be strengthened further,
giving due consideration to
these recommendations, as follows:

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

Close coordination with hospital

personnel in the identification of
stroke survivors and families who
could be beneficiaries of CBRP services.

This process should begin

immediately during the patients
hospital stay . Since this study
utilized DOH-retained hospitals as
contact points, this is where the
collaborative linkage should begin.

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

The link is important for CBRP

implementors , for purposes of
monitoring and evaluation of
patients progress. Moreover, it is
crucial for caregivers to have a
sense of support for the
caregiving role in the critical
transition point between the
hospital and the home.

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers

Partnerships with family members

of disabled persons (such as stroke
survivors)

OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

The family caregiver, in

particular, must be included in
CBRPs training of trainers on
basic rehabilitation services, in
addition to other identified
volunteers from the community.

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers

Establishment of a pool of
community volunteers who could
serve as proxy caregivers

OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

Periodic relief for caregivers

from CBRP community
volunteers could reduce
caregiving strain considerably.

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers

Formation of social support

networks within the community
for stroke survivors

OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

A caregiver support group can

be a strain reliever for family
caregivers.
Interaction of these two groups
could spell a better
understanding of their
respective situations.

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

Mechanisms for a continuous and

regular evaluation of the demand
for rehabilitation services should
be instituted
IEC campaign within the
community regarding health
promotion in general and disability
prevention in particular

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

Media campaign activities on the

prevention and causes of disability
(particularly stroke) with a
national audience
The design of 30-second radio and
television spot advertisements
should be an effective strategy for
better audience retention.

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers

W iden the geographical coverage

area of CBRP services in order to
reach the clientele it seeks to serve

OBJECTIVES

METHODOLOGY

Link with community health centers

LIMITATIONS

Health services offered by the

health center should be
expanded to include rehabilitation
health services and manned by
trained personnel to deliver the
services needed by its target
clientele.

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

O ld e r

persons
and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

RECOMMENDATIONS
Policy
A national subsidized home care
program for Persons With
Disabilities (P W D s )
This subsidy moreover would
encourage families to take care
of their disabled elderly member
by providing them resources for
their basic needs - proper diet,
medicines, some capital for
income-generating projects, and
some means to make them
participate in community activities.

O ld e r

persons
and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RECOMMENDATIONS
Strengthen and broaden rehabilitation
and health services for disabled
persons through:
Lobbying for the passage of
legislation that would provide
for the inclusion of temporary
and long-term support of families
with disabled members, particularly
the elderly.

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

Reimbursement for home care of

P W D s , particularly lay caregivers
of disabled persons, may be the
significant centerpiece of this
legislation.

O ld e r

persons

RECOMMENDATIONS

and their

care
g ivers
OBJECTIVES

METHODOLOGY

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R EECCO M
O M
MENDATION

Development of awareness programs

for local officials, community leaders
and families to consolidate and
reinforce their role in facilitating the
improvement of health rehabilitation
services within the community context.

O ld e r

persons

Making the study results

useful and practical

and their

care
g ivers
OBJECTIVES

METHODOLOGY

what every
family caregiver of
older persons
should know

LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION

A Primer

English version

O ld e r

persons

Making the study results

useful and practical

and their

care
g ivers
OBJECTIVES

mga dapat malaman

ng tagapagkalinga
sa mga nakatatandang
kapamilya

METHODOLOGY

LIMITATIONS

RESULTS

Isang Praymer
SUMMARY OF
RESULTS
R E C O M
MENDATION

Tagalog version

O ld e r

persons
and their

care
g ivers
OBJECTIVES

stroke as a critical life event in the

METHODOLOGY
Filipino family
LIMITATIONS

RESULTS
SUMMARY OF
RESULTS
R E C O M
MENDATION