Feelings of abandonment among elderly people in rural Thailand : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Health Sciences at Massey University, Palmerston North, New Zealand

Abstract

The study was focused on feelings of abandonment among elderly people whose children had left their home villages in rural Northeast Thailand. Sequential mixed methods were employed. A cross-sectional survey (Study A) was used to determine (1) the extent and degree to which older persons living in a rural area of Northeast Thailand felt abandoned by the migration of their children from their home province; (2) the factors which affect feelings of abandonment; (3) the impact that feelings of abandonment had on their quality of life. Ethnographic methods (Study B) were then used to gain an in-depth understanding of the experiences and meaning of abandonment from the perspectives of those who identified as feeling abandoned or not feeling abandoned. Furthermore, data were obtained and analysed that highlighted the way in which the two groups solved problems when facing difficult circumstances. A cross sectional survey, consisting of 113 questions including the 26-item WHOQOL-BREF and the 24-item WHOQOL-OLD was administered to 212 participants who ranged in age from 60 to 107 with a mean age of 71. While only 9% were found to live alone, 20% stated that they felt abandoned to some degree. To identify the factors which may impact on feelings of abandonment, participants were assigned to groups based on their stated feelings of abandonment (i.e., abandoned / not abandoned) and compared on 21 variables. They were found to differ on 7 of those (i.e., age, level of education, whether they lived alone or with others, satisfaction with living arrangements, frequency of contact with any of their children, degree of economic hardship, and family support). A standard multiple regression was performed to predict variance of feelings of abandonment using those 7 variables. These variables predicted 23% of variance in feelings of abandonment in this sample. Only 4 variables (i.e, frequency of contact with any of their children, living alone or with others, degree of economic hardship and family support) were found to make a unique and significant contribution to this prediction. A one-way between groups MANOVA was conducted to determine if those who felt abandoned differed from those who did not on a single-item question of overall quality of life and the total scores for the WHOQOL-BREF and WHOQOL-OLD. Significant differences were found between groups on the total scores for the WHOQOL-BREF and the WHOQOLOLD only. Participants in Study B were initially selected from those in Study A and supplemented by purposive sampling in the study setting. Twenty-five participants, 14 who felt abandoned and 11 who did not feel abandoned were recruited. Data collection involved participant observation and in-depth interviews. Thematic analysis was employed for data analysis. The findings from Study B were that the reasons for feeling abandoned (as perceived by elderly parents) are constructed from children’s actions perceived as negative by parents, economic hardship, illness/spouse’s sickness, and hopelessness. Of these reasons, only two were also identified in the cross-sectional survey the frequency of negative contacts with children and degree of economic hardship showed as quantitative measures of abandonment. Problem solving by participants is formulated from several bases: using Buddha’s teachings, acting positively towards their children, focusing on life’s satisfaction, finding financial solutions, seeking support and dealing with sorrow. Recommendations made as a result of this study draw attention mainly to the minimization of the negative effects of labour migration on elders. In addition, the government, health care workers, and community should play an active role in taking care of those old persons left behind, especially aging people who live alone, by providing community bases and home health care services rather than increasing institutional services. This could substantially change the implications of migration on the well-being of the parents, especially when illness or frailty occurs and daily personal assistance is needed.