The Relationship between Activity Independence Level and Anxiety Level of Elderly in Budi Mulia 3 Service, 2022

Elderly (elderly) is a condition that occurs in the human life cycle. Many health problems occur in the elderly, especially problems of movement and independence of the elderly in meeting their daily needs. Problems due to decreased health status and body function can exacerbate the health condition of the elderly. This study aims to identify the relationship between the level of activity independence and the anxiety level of the elderly. The method used in this study uses correlation analysis with a cross sectional approach. The population in this study used all inmates who were at the Budi Mulia 3 Social Institution, taking samples using a purposive sampling technique that met the inclusion criteria. Data collection using questionnaires and observation sheets. The results showed that out of 50 respondents, 15 respondents were independent in fulfilling needs and 35 respondents experienced dependence, while the level of anxiety of 50 respondents, 28 respondents experienced mild anxiety, 19 respondents experienced moderate anxiety and 3 experienced severe anxiety. Based on the results of the statistical correlation test, it was found that there was a relationship between the level of independence in carrying out activities and the level of anxiety in the elderly.


Introduction
Elderly or aging is a condition that occurs in human life.Getting old is a natural process, which means that a person has gone through three stages of his life, namely children, adolescents and adults.These three stages differ both biologically and psychologically.The developmental resistance of the elderly is very different from the previous resistance.Changes in development and changes in body structure and function in the elderly will become new problems for the elderly.Physical changes that occur in the elderly are caused by several factors that will affect and many problems will occur in the elderly, for example physical deterioration, which is characterized by sagging skin, graying hair, teeth starting to be toothless, hearing is less clear, vision is getting worse, movement is slow and disproportionate body figures (Sonza et al., 2020).Psychological changes in the elderly will appear symptoms of anxiety, spiritual distress, helplessness to grieving due to the loss of a partner.
Physical changes that occur in the elderly can cause impaired independence in meeting daily needs.The independence of the elderly in fulfilling their daily activities is defined as a person's independence in carrying out activities and functions of daily life which are carried out by the elderly routinely and universally.Problems that arise due to decreased independence can cause physical and psychological disorders.
Physical disorders can occur due to the elderly being unable to carry out daily activities such as deformities in the body due to lying in bed for too long.In accordance with previous research, it was stated that one of the factors that influence the independence of daily activities in the elderly is anxiety (Sonza et al., 2020).Anxiety that occurs in the elderly can cause a decrease in physical and mental conditions, increased exposure to death, and social support that gradually decreases due to being away from family (Yusli & Rachma, 2019) Mental problems that are usually experienced by the elderly occur due to changes in roles in the elderly, inability to fulfill needs, limitations in activities and various other disabilities in the elderly that are associated with decreased cognitive and affective function in an elderly person.Psychological problems are more common in elderly such as anxiety, helplessness and hopelessness to the point of loss.According to (Annisa & Ifdil, 2016) The increasing number of elderly people in Indonesia will certainly cause various problems and problems that will arise both physically and psychosocially.
Anxiety is confusion, worry about something that will happen to the elderly, anxiety in the elderly can be caused by things that are not clear and are associated with feelings of uncertainty and helplessness.Basically, anxiety is a natural thing that every human has ever experienced.Anxiety is considered as a part of everyday life.Anxiety that occurs in the elderly will further exacerbate the condition of the elderly, especially the elderly who live in halfway houses or social institutions.Inadequate environment and inadequate family support are factors that will exacerbate the condition of the elderly.The purpose of this study was to identify the relationship between the level of independence and the level of anxiety in the elderly who are at the Tresna Werdha Budi Mulia 3 Social Institution.

Method
The type of research used is analytic research with a cross-sectional design where researchers will measure research variables at the same time, namely the relationship between the level of independence and the golden age of the elderly at the Tresna Werdha Budi Mulia 3 Social Institution.
The population in this study were the elderly who were at the Tresna Werdha Budi Mulia 3 Social Institution and the sample from the study were the elderly who met the inclusion criteria, namely the elderly aged > 60 years, living at the Tresna Werdha Budi Mulia 3 Social Institution, able to communicate actively and not with cognitive impairment.The sampling technique is non-probability sampling with a purposive sampling technique, namely sampling is not based on strata, random or region but for a specific purpose of 50 people.The instrument in this study was to use a questionnaire.
For the elderly independence variable the researcher used the Barthel Index scale, this Barthel index scale has been carried out in previous research by Nuzul in his research (Nuzul et al., 2020).Anxiety variable using the Geriatric Anxiety Inventory (GAI).The questionnaire that the researcher uses is a questionnaire that has been used by previous researchers.

Result and Discussion
This research was conducted from November 7 to December 23, 2022 with 50 elderly respondents.From the results of distributing the questionnaires, the following results were obtained:  Elderly is a natural process that occurs in a person, this process occurs after passing through the end of adulthood and this is the final stage of life.This process occurs continuously when a person experiences several changes that affect the function and ability of the whole body.In accordance with research that has been researched by (Pranata et al., 2020) which states that the problems that are often faced by the elderly over time, namely a decrease in various functions of the body's organs, especially in cognitive and psychomotor functions.Psychomotor disorders in the elderly can cause the elderly to be unable to carry out daily activities in carrying out activities.The inability of the elderly to move or carry out daily activities, the elderly are also at risk for trauma and falls (Eni & Safitri, 2019) Anxiety is a psychological condition or form of individual emotion in the form of tension, anxiety, worry regarding feelings of being threatened and fear by uncertainty in the future that something bad will happen.In the elderly this can occur as a result of body functions that have begun to decline, similar to what was conveyed by previous researchers (Welzel et al., 2019) that anxiety in the elderly can be influenced by internal and external factors.External factors are threats to physical integrity and threats to the self-system and internal factors, namely age, stressors, gender, environment and education.The results of this study are almost the same as previous researchers (Rindayati et al., 2020) where the level of anxiety that occurs in the elderly is at the golden level of the mild stage while moderate and severe anxiety to panic is not found.
Based on the results of statistical tests using the SPSS program it was found that p value = 0.000 ≤ 0.05, so from the results of this test it can be concluded that there is a relationship between the level of independence and the level of anxiety experienced by the elderly at the Tresna Werdha Budi Mulia 3 Social Institution.This can be seen from the results of observations and questionnaires that have been distributed which prove that the elderly with a mild level of independence experience anxiety at a mild level.The anxiety level of the elderly can be influenced by the decreasing ability of the elderly to meet their daily needs.
Elderly anxiety also arises due to fear of someone asking for help in meeting daily needs.The elderly refrain from doing activities more than having to ask for help from officers.Elderly who are able to meet their daily needs are seen to be more productive and able to participate in programs that have been scheduled by the orphanage.
In line with research (Sonza et al., 2020) which states that the higher the level of anxiety, the lower the Activities of daily living in the elderly.The results of this study are also in line with research (Abdul Aziz Azari, Mohammad Ilham Zururi, 2021) which states that the elderly will feel anxious and worried about their condition being unable to perform ADLs so that it can cause depression in the elderly.
This research is also almost the same as previous studies which stated that elderly people who have good social independence are better able to interact with their environment and are able to communicate well (Sulantoro et al., 2018).The ability and independence of the elderly greatly influences the interaction of the elderly in social life in the environment where the elderly live.

Summary
There was a relationship between the level of independence in carrying out activities and the level of anxiety in the elderly.The ability and independence of the elderly greatly influences the of the elderly in social life in the environment where the elderly live

Table 1 .
Distribution of the level of independence of the elderly in Tresna Werdha Budi Mulia 3

Table 3 .
The relationship between the level of independence and the anxiety of the elderly at the Tresna Werdha Budi Mulia 3 Social Institution (n = 50)