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Changes in Living Circumstances for the Aged in Saudi Arabia: Can Occupational Therapy Make a Difference?
Population aging is one of the most severe challenges the world has faced. Saudi Arabia is no exception to the general rule. As of the end of 2015, people over 60 years old made up around 5 percent of the overall Saudi population. In addition, those aged 80 and more were around 1 percent of the total population of the country. More than that, there are projections that point that this figure is to continue increasing, reaching almost a quarter of the Saudi population by 2050 (Abusaaq, 2015).
There are several causes of such spectacular growth. Improvement of the country’s economic development, stable rates of economic growth, better health care services are just a few of them (Abusaaq, 2015). Altogether, they increase life expectancy, thus making the problem of aging even more significant.
It is critical to note that there is a connection between population aging and the provision of health care services. As the number of the elderly is constantly growing, there is an increasing need for delivering professional care to them. In most cases, they require specific attention and a lot of time to spend in order to satisfy their needs.
The issue is even more challenging in case of disabilities or partial immobility of an aged person. In this way, it is crucial to develop an effective system of occupational therapy for the elderly. However, the problem with achieving this objective lies in the specificities of the Saudi worldview and apprehension of growing old.
Therefore, the objective of the given paper is to investigate the current system of occupational therapy operations in Saudi Arabia and identify the gaps to fill. The idea for reaching it is to compare the existing system with that of Australia and recommend particular changes that would benefit the elderly and help them to adapt to the changing living circumstances as well as satisfy their needs.
Problem Statement
Occupational therapy is a common practice in most developed countries due to its effectiveness in providing care to the elderly. In most cases, it involves either receiving care at specially designed and operating nursing homes or reorganizing an individual’s home to satisfy their particular needs. In addition, the practice is in a common connection with either nurses (visiting or those working in nursing homes) or unprofessional care of family members or specially hired people.
In the case of Saudi Arabia, there is a conflict of worldview and comfort of the elderly and their family members because younger family members are responsible for their older relatives. It means that there is an established tradition of getting old at home, and leaving for a nursing home is unacceptable.
It is essential to note, that according to Karlin, Weil, and Felmban (2016), almost no elderly people feel the support of the Saudi government when it comes to satisfying their special needs. In this way, they believe that they should grow old at home with their families. More than that, the number of occupational therapists is extremely low – around 20 professionals per 100,000 citizens (Qureshi, Al-Habeeb, & Koenig, 2013).
In addition, women were traditionally responsible for caring for the elderly. Nowadays, because of the growing employment rates of women, as well as their increasing mobility, it is complicated to carry out this function (Abusaaq, 2015). So, in view of population aging and the growing number of older people, as well as other changes, this tendency is troublesome, and taking some steps is necessary for overcoming the existing challenges.
Search Strategy
Initial Searchable Question
The focus of the study is occupational therapy for the elderly in Saudi Arabia. For this reason, the research question centered on the change of living circumstances and the role of occupational therapy in the wellbeing of society. It was the following, “In the elderly people of Saudi Arabia, does occupational therapy make a difference under changing living circumstances?”
However, because the primary idea of the research is to find out what steps can be taken to improve the current situation, it was imperative to conduct an additional study on occupational therapy in developed countries. In this way, Australia was chosen as an example. That is why there was one more searchable question, “What are the specificities of occupational therapy for the elderly in Australia?”
Databases Searched
In order to locate relevant literature, several databases were searched. The initial search was conducted via the Google Scholar database. Nevertheless, to make the process more comprehensive and effective, some other databases were chosen, such as PubMed, Medline, and Scopus, due to their focus on health-related and medical issues.
Search Terms
Because there were two research questions, there were several different terms used for finding the necessary sources of information. Some of them included the following: “occupational therapy in Saudi Arabia,” “occupational therapy of the elderly in Saudi Arabia,” “Saudi system of occupational therapy,” “occupational therapy in Australia,” “treating the elderly in Australia,” “living conditions in Saudi Arabia,” “factors affecting occupational therapy of the elderly,” “current state of occupational therapy in Saudi Arabia,” etc. Therefore, keywords are occupational therapy, Saudi Arabia, the elderly, and Australia.
Inclusion and Exclusion Criteria
Because of the specific objective of the given research, there were several critical inclusion and exclusion criteria. To begin with, the idea was to focus on relevant information and study only reputable sources. That is why locating materials published in peer-reviewed and scholarly journals were the major inclusion criteria.
Still, to make the background of the study comprehensive, books were not ignored. Moreover, due to the necessity to make conclusions based on up-to-date information, only those sources published since 2012 were taken into consideration. Finally, the language of publication was one more inclusion criterion.
In this way, all information published in other than the English language, earlier than in 2011, and on the websites (except for.sa websites browsed for statistics), in newspapers and magazines was not selected. So, these were the main exclusion criteria.
Refined Research Question
Based on a comprehensive literature search, the research question was modified. So, the paper is based on the following one, “Compared to Australia, what are the ways for improving the system of occupational therapy for the elderly in Saudi Arabia?”
Search History
Due to a large number of search terms, search history was broken into several steps based on a search request. However, having a set of inclusion and exclusion criteria helped to make the process less troublesome and locate relevant references. All sources chosen for the final analysis are indicated in the table below.
Results
Occupational Therapy of the Aged in Saudi Arabia
As for now, the system of occupational therapy is a relatively new field of care. Religious and moral values are just some reasons that can help to explain the fact that this kind of service is unpopular. In addition, slower rates of population aging compared to those of the Western world as well contribute to the maintenance of the current situation.
Still, there are several areas of care. According to Aleisa, Al-Sobayel, Buragadda, and Rao (2014), occupational therapy is a part of rehabilitation. In most cases, patients with disabilities and chronic conditions undergo it in order to return to work and reintegrate into society. Nevertheless, similar measures are limited in time. Moreover, due to the novelty of the system, there is a lack of occupational therapists, who would deliver adequate professional care to all in need (Aleisa et al., 2014; Khan & Alam, 2014).
Another kind of occupational therapy is hiring an outside person to take care of an elderly family member. The advantage of this form of help is adherence to Saudi traditions of growing old at home. Still, there are some challenges, which derive from the fact that employed nurses are commonly foreigners, so that existing cultural gaps affect the level of provided care and comfort of a patient.
Australian System of Occupational Therapy of the Elderly
Unlike Saudi Arabia, in Australia, occupational therapy of the elderly is a common practice. In most cases, there are groups of specially trained professionals who take care of the aged people as well as collaborate with health care professionals both within the national health care system and in the international arena (Barney & Perkinson, 2016).
In addition to it, in Saudi Arabia, there is a constant lack of governmental financial support for occupational therapy programs. Instead, the source of financing is religious and nongovernmental organizations, which either do not have enough resources or do not want to back up the evolution and improvement of this field of professional care (Abdulrahim, Ajrouch, Jammal, & Antonucci, 2012).
Unlike Saudi Arabia, this sector enjoys governmental support in Australia together with financing and promotion. There are vast investments in training professionals and arranging nursing homes in order to satisfy the specific needs of the elderly, especially those with disabilities or chronic conditions and diseases (Wales, Clemson, Lannin, & Cameron, 2012).
Finally, in Australia, there is a constantly operating governmental institution responsible for governing and supporting occupational therapists – the Occupational Therapy Board of Australia. In this way, there is not only support but also permanent control over occupational therapists, their professionalism, and the quality of provided services. Due to the existence of this body, there is a guarantee of sharing the best and newest practices with health care professionals that are helpful for addressing the needs of the elderly.
Ways to Improve Saudi Occupational Therapy
In order to improve the system of occupational therapy in Saudi Arabia, it is advisable to both take advantage of existing strengths and adopt international experiences. To begin with, there are some particularly strong aspects of the Saudi environment that could be helpful for overcoming existing challenges. For instance, there are numerous skilled and well-educated physicians and therapists (Aleisa et al., 2014). Except for providing services to Saudi citizens, this benefit attracts foreigners who seek professional medical aid – so-called medical tourism (Khan & Alam, 2014).
In addition, the existing educational and academic environments are well-developed, which means that there is an opportunity for training more skilled professionals (Aleisa et al., 2014). In this way, we believe that in order to make the operating system of occupational therapy more effective, it is advisable to reorganize and relocate existing resources. In fact, there is no lack of professionals in other areas of medical aid. So, rearranging them in the field of occupational therapy would help to solve the deficit in it.
More than that, it is critical to gain the governmental support of occupational therapy programs. In Australia, for example, besides financing, the government promotes the operation of nursing homes and visiting nurses. From this perspective, our opinion is that it is essential to obtain the same support from the Saudi government. We believe that current challenges with occupational therapy derive from the fact that most religious and nongovernmental organizations finance these institutions.
If the government allocated necessary funds, it would eliminate the problem of inadequate and unprofessional help provided to the elderly members of society. Here, it is imperative to note that this recommendation is most likely to come to life if the ratio of the elderly does increase to 25 percent by 2050. In other words, fostering the involvement of the government and arranging nursing homes is the only way to guarantee the wellbeing of the aged citizens as well as their families. That said, improving organizational and governmental environments is another recommendation for making the system of occupational health in Saudi Arabia operational and efficient.
Finally, it would be beneficial to adopt another Australian practice – establish a board of occupational therapists. As for now, there is no similar body in Saudi Arabia. As for carrying out its functions, it is the responsibility of local hospitals, which hire occupational therapists. It means that not all health care facilities have such specialists so that they cannot deliver care to all patients and address some specific needs of the elderly. From this perspective, creating such an institution and making it responsible for licensing occupational therapists and investing in constant upgrading of their skills and knowledge would make the whole system more effective.
Discussion
Strengths
This research is an attempt to systemize the latest findings pertaining to the strengths and weaknesses of occupational therapy practices operational in Saudi Arabia. To the best of our knowledge, this study is the first comparison of Saudi and Australian systems of occupational therapy of the elderly that offers recommendations for improving the status of the aged and procedures for taking care of them.
Limitations
Regardless of apparent strengths, this research has several limitations. For instance, the character of recommendation is theoretical. Because all of them derive from the comparison with Australian practices, they are not comprehensive. Finally, the foundation of the research is secondary data, i.e. there is a risk of irrelevant conclusions due to mistakes or inaccuracies of initially selected sources.
The implication for Future Research
Based on what we mentioned above, there are several potential directions for future research. For instance, it is advisable to study the experiences of other developed countries such as the United States of America and European states. More than that, to improve the Saudi system of occupational therapy, it would be beneficial to review the other Arab States and currently deployed practices.
Conclusion
In summary, it is advisable to take several steps in order to increase the effectiveness of the operating system of occupational therapy in Saudi Arabia and make a difference for the elderly in view of population aging. The primary idea is to follow an example of Australia and adopt some of its practices, making them country-specific. The rationale for choosing Australia for comparison is the fact that the countries are similar because most concerns arise when it comes to those older than 70 (Wales et al., 2012). The same is true about Saudi Arabia (Abusaaq, 2015).
All of the recommendations come down to comprehensive and deep reforms in society and government. Because nowadays, the Saudi educational and medical environments are ready for necessary transformations due to a high level of expertise and professionalism, the only challenge is to find levers and enhance participation and support of the Saudi government. More than that, it is critical to establish a state-governed body that would control the quality of provided services and professionalism of operating occupational therapists.
That said, answering the key question, occupational therapy of the elderly is the key to the wellbeing of Saudi society in the future. The continuous tendency of population aging is not the only reason for making this statement. Instead, constantly growing numbers of the elderly, as well as increased life expectancy, lead to the need for special care because they are inseparable from the discomfort of other family members. Even though nowadays this challenge is not extremely severe yet, we believe that it is essential to take necessary steps before the situation is hard to control because any change requires time for implementation.
References
Abdulrahim, S., Ajrouch, K. J., Jammal, A., & Antonucci, T. C. (2012). Study methods and aging research in an Arab sociocultural context: A case study. Journal of Gerontology, 67(6), 775-782.
Abusaaq, H. I. (2015). Population aging in Saudi Arabia. Web.
Aleisa, E., Al-Sobayel, H., Buragadda, S., & Rao, G. (2014). Rehabilitation services in Saudi Arabia: An overview of its current structure and future challenges. Journal of General Practice, 2(6), 184-187.
Barney, K. F., & Perkinson, M. A. (2016). Occupational therapy with aging adults: Promoting quality of life through collaborative practice. St. Louis, MO: Elsevier.
Karlin, N. J., Weil, J., & Felmban, W. (2016). Aging in Saudi Arabia: An exploratory study of contemporary older persons’ views about daily life, health, and the experience of aging. Gerontology and Geriatric Medicine, 2(1), 19-28.
Khan, S., & Alam, S. (2014). Kingdom of Saudi Arabia: A potential destination for medical tourism. Journal of Taibah University Medical Sciences, 9(4), 257-262.
Qureshi, N. A., Al-Habeeb, A. A., & Koenig, H. G. (2013). Mental health system in Saudi Arabia: An overview. Neuropsychiatric Disease and Treatment, 9(1), 1121-1135.
Wales, K., Clemson, L., Lannin, N., & Cameron, I. D. (2012). Functional assessments used by occupational therapists with older adults at risk of activity and participation limitations: a systematic review and evaluation of measurement properties. Systematic Reviews, 1(1), 45-50.
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