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As ageing is an upcoming issue in low-income countries, an increase dependence on familial support is expected. Yet, traditional familial support mechanisms are threatened by declining family size, urban migration and globalisation. Our aim for this qualitative study was to explore the personal experiences and perception of elderly Pakistani patients about social and family support dynamics. The study was nested in a larger quantitative study. Patients attending the outpatient department of a tertiary care hospital were interviewed. Content analysis of data resulted in identification of one main theme, “Ageing exposes limitations in the support systems to address disability, reliance and vulnerabilities” and two sub-themes, (1) Disability and Vulnerability; (2) Support and Expectation. The driving forces behind limitation in the support systems were functional disability, illness, inability to pay for healthcare, and disobedience and expectations from children. In addition, due to lack of old age social benefit systems elderly became dependent on their children for their physical and emotional care. They perceived old age as a tough stage of life, and felt themselves as a financial burden on their children. The elderly cited the concern regarding deteriorating social support system due to a crumbling value system of the society. Further, looking after the elderly was a value and responsibility of the children, society and government. Most of the participants refused to avail alternative accommodation like old homes, as they wanted to live with their loved ones in the current setup even with all difficulties. Strengthening of systems could enable elderly to cope. [ABSTRACT FROM PUBLISHER]

As ageing is an upcoming issue in low-income countries, an increase in the prevalence of functional disability among older citizens is expected, paralleled with increase dependence on familial support. The study examines the occurrence of functional disabilities among older people in a low-income setting and its association with individual familial support. Data were gathered from a sample of 136 patients aged 60+ years attending a tertiary healthcare hospital in Islamabad. Assessments of functional disability (ADL and IADL) and familial support were made using a standardised questionnaire. Disability (yes/no) was assessed for each of 15 functional disability items. Thereafter, the association between disability (on any item) and each (also dichotomised) component of three dimensions of familial support (instrumental; social and emotional) was measured using Fisher exact test (a total of 15 components). 69% of the subjects qualified as disabled. Disability was more common in IADL than ADL activities. There was a significant difference between disabled and non-disabled persons as regards several forms of instrumental support they received, to the benefit of the disabled. There was not much difference in social and emotional support. The fact of being disabled seems to be associated with individual sociodemographic status, to the detriment of women, illiterate and non earners. Disability is prevalent among older people in Pakistan, occurs at an early age and is associated with the familial support received, particularly instrumental support. There is a need to understand these associations better to allow older people to realise their healthy life potential. [ABSTRACT FROM PUBLISHER]