Comparison of the Perception of Rejection and Depressive Syndrome Resident in the Elderly Living in the Nursing Home and Resident at Home

The concern about the quality of life of the elderly living in resident at home and nursing homes has been one of the controversial issues. Some studies believe that if the mental health of the elderly is provided and a suitable atmosphere is created in the nursing homes, better health care and treatment can be provided to the elderly and their life expectancy can be increased; But on the other hand, some studies believe that caring for the elderly at home and with other family members can have an effective role on their psychological health; so that the results of some studies indicate that this group of elderly people have a higher life expectancy; But on the other hand, it can threaten their physical health and make them prone to other chronic diseases and malnutrition. Admission to a nursing home evokes emotional consequences, including feelings of rejection, psychological tension, depression, instability, loss of home and the chance to contact family and friends. Research shows that the living environment of the elderly plays a very important role in their psychological health. It has been shown in various researches that the level of quality of life and mental health, happiness and social health in the elderly living in nursing homes is lower than that of the elderly living at home; Based on this, it can be concluded that there is a relationship between living in a nursing home and the psychological state of the elderly, but it cannot be said with certainty that the low mental health of the elderly indicates living in a nursing home; Because some studies have shown that the diseases and disabilities of elderly people living in nursing homes are more than other elderly people, and disabilities lead them to care centers; Maybe this factor also has an effective role in reducing their mental health. Based on this, the implementation of a comparative study in the elderly with high performance and control of physical disabilities will clarify the role of living in a nursing home in the state of mental health of the elderly, which is addressed in the present study. Also, some studies indicate that the stay of the elderly in the nursing home is associated with the feeling of exclusion and their feeling of loneliness plays an effective role. Also, the research showed that the elderly living in the nursing home experienced a feeling of insecurity and rejection and described their transition from home to the nursing home as painful; In other words, living in a nursing home can have an effective role in reducing the mental health of the elderly. Elderly people who have a high level of rejection feel that they are of no use to themselves and those around them and cannot be effective; Also, the results of this study showed that the feeling of rejection, due to its high relationship with social incompetence, has an effective role in increasing depression symptoms in these elderly people; Based on this, it can be concluded that living in a nursing home, rejection and depression are closely related. In this regard, the results of some studies show that the elderly living in nursing homes have far more symptoms of depression, anxiety and stress and report less satisfaction with life. Nowadays, due to the increase in the number of elderly people and the shrinking of families, caring for the elderly is a very important issue, and detailed and comprehensive programs for the care of this sensitive age group should be provided by conducting field research and formulating detailed care policies. Compared to younger people, older people with depression usually have multiple co-occurring medical and cognitive disorders, and depression that occurs in older patients is often underdiagnosed or undertreated. Also, previous studies have shown that inactivity and disability are factors affecting the feeling of exclusion of the elderly; which, if accompanied by family rejection, can lead to an increase in psychological distress in the elderly. Considering the importance of this topic, the present study compared the perception of rejection and depression symptoms in elderly people living in nursing homes and resident at home.

The current research was descriptive and based on causal-comparative method. The statistical population of this research includes two groups of elderly people in Rasht city in 2020 who were living in nursing homes or living with their families. The sample size was calculated using G*Power software. From each group, 120 elderly people participated in a targeted manner and answered the Perceived Rejection Scale: PRS and the Geriatric Depression Scale: GDS-15. For both groups, the age gap is between 65 and 90 years, having minimum physical health to communicate and answer the questions of the questionnaire, not suffering from cognitive impairment diseases such as (Alzheimer, stroke and dementia), not being engaged in economic activity. And retirement from governmental and non-governmental institutions and having informed consent and willingness to participate in the research were considered as entry criteria. Also, failure to answer at least 10% of the questionnaire questions, fatigue and unwillingness to complete the questionnaire were considered as exit criteria. Data analysis was performed using SPSS-24 statistical software and multivariate analysis of variance.

The results of multivariate analysis of variance showed that the perception of rejection (F = 14.25, P = 0.001) and depressive syndrome (F = 17.280, P = 0.001) in the elderly living in nursing homes were significantly higher than the elderly were in the control group (P <0.001).

Overall, the results of this study showed that the perception of rejection and depression symptoms in elderly people living in nursing homes is more than that of elderly people living at home; But this difference cannot be attributed to the presence of the elderly in the nursing home. But in general, it can be concluded that elderly people living in nursing homes are more in need of appropriate interventions and educational programs to reduce the feeling of rejection and depression symptoms than the elderly people living at home. Therefore, it is suggested to provide educational and therapeutic programs to improve the psychological condition of these elderly people.