Perceptions and experiences of elderly patients receiving chiropractic care in the Durban Metropolitan area

Abstract

Background: The elderly population experience a significant musculoskeletal burden. Both the population and their healthcare burdens are expected to increase due to the elderly’s extended life expectancies. This escalating healthcare burden falls to the public healthcare sector, on which the majority of the population relies in the South African context. The current experiences of elderly individuals in this public system are poor due to the disease centred approach implemented in care. Chiropractic care implements a patient-centred approach to healthcare which is more suitable to meet the needs of this vulnerable population. Chiropractic care effectively manages musculoskeletal conditions; however, it remains largely underutilised by the public. In South Africa, Chiropractic Care’s public presence is limited to two university clinics due to the outdated legislature restricting the profession in the public healthcare sector. This limits the public exposure to Chiropractic Care’s non-invasive and non-pharmacological approach for managing musculoskeletal pain. There is limited research in both the local and international contexts into the perceptions and experiences towards Chiropractic Care from the elderly’s perspective, therefore demonstrating the value of additional research into this topic. Aim: This study aimed to explore the perceptions and experiences of elderly individuals receiving Chiropractic Care in the Durban Metropolitan area. Method: This qualitative study was conducted utilising an exploratory, descriptive approach. A random-purposive sampling of 11 elderly individuals with at least one previous Chiropractic Care experience was implemented. Semi-structured interviews were performed to provide insights into the perceptions and experiences of this population. Thematic analysis was performed using the Tesch method. Results: Thematic analysis extracted six themes, including understanding of Chiropractic Care; factors influencing the pursuit of Chiropractic Care; the impact of care on the elderly experience; insights provided through lifetime experiences; the impacts of age on the elderly experience; and the attraction of an alternative healthcare approach. Conclusion: This analysis indicated that although understanding of Chiropractic Care was limited by this population, all elderly participants shared positive perceptions of Chiropractic Care. A lack of language eloquence was observed when participants discussed Chiropractic terminology. New Chiropractic Care experiences have the potential to change the previous negative perceptions, while misinformation can be combated through patient education. Recommendation-based pursuit of Chiropractic Care is insufficient, and a focus on exposing new individuals to Chiropractic Care through alternative methods, such as community outreach, should be prioritised. The patient-centred approach in Chiropractic Care created a positive healthcare experience for the elderly individuals in this study. The elderly felt age had minimal impact on the Chiropractic Care they were provided, compared to the age based discrimination they experienced in the mainstream public sector. When the clinical care provided to the elderly is substandard, the negative perceptions of ageing and the ability to successfully access care are reinforced. Chiropractic care was viewed by the elderly as a superior healthcare alternative to the pharmacological and surgical options they were traditionally offered.