Unmet Needs for Personal Assistance with Activities of Daily Living among the Elderly in Rural and Urban Communities in Nigeria: Determinants and Policy Implications

Abstract

Background: Understanding the extent of the determinants of unmet needs for assistance with activities of daily living (ADL) among the elderly is germane in formulating the right policies. Objectives: This study assessed the determinants of unmet needs for assistance with ADL among the elderly in rural and urban areas in Kwara State Central Senatorial District, Nigeria. Materials and Methods: It was a cross-sectional analytical study. Data were collected, using a pre-tested semi-structured interviewer-administered questionnaire from 300 elderly persons using the multistage sampling technique. Data analysis was done using IBM Statistical Package for Social Sciences (IBM-SPSS) version 20. The level of significance was predetermined at a p-value less than 0.05 at 95% confidence level. Results: The significant odds of having unmet needs for assistance with ADL in the rural group were amongst the unemployed (OR= 3.422 p=0.002), those with morbid conditions (OR= 2.285, p=0.032), who had >4 ADL difficulty (OR= 8.167, p<0.001), had no children as carers (OR=9.205, p<0.001) or no children alive (OR=17, p=0.018, however, widowed (OR= 3.918, p <0.001), females (OR= 4.098, p= 0.001), and persons not cohabiting with children (OR=2.154, p=0.043) were for the urban group. Persons without children as carers in the rural group were almost 5 times more likely to have unmet needs for assistance with ADL (AOR 4.714 p=0.002). Conclusion: There were different determinants of unmet needs for assistance with ADL among the elderly in rural and urban areas. The Government of Nigeria should develop and implement innovative policies to improve the care of the elderly.