Elderly Posyandu Services in Improving the Quality of Life of the Elderly at the Mekar Health Center, Kendari City

This study aims to understand the Services of the Elderly Posyandu in Improving the Quality of Life of the Elderly at the Mekar Health Center in Kendari City along with How to Support the Services of the Elderly Posyandu at the Mekar Health Center in Kendari City. The research method used in this research is a qualitative descriptive method. Meanwhile, the data collection techniques used are observation, interviews, and documentation. The informants in this study are posyandu cadres and the elderly at the Mekar Health Center in Kendari City. The data sources used are primary data sources and secondary data sources. The results of this study concluded that the Elderly Posyandu Services in Improving the Quality of Life of the Elderly at the Mekar Health Center in Kendari City are in the form of health services, supplementary feeding, sports activities, non-health activities, facilities and infrastructure. The service supporters at the elderly posyandu are the youth factor, supporting factor, and strengthening factor.


INTRODUCTION
The elderly are a group of people who are experiencing a gradual process of change over a certain period of time.The changes that occur include physical, biological, cognitive, psychological, economic, and social roles in society.Often the elderly and the people around them cannot accept the changes and setbacks that occur so that it will cause problems for the elderly.For this reason, the elderly population needs to get coaching and services so that they can be more qualified and productive so that they can achieve prosperity in their lives.A person is said to be elderly if he is 60 years old or older, because certain factors cannot meet his basic needs both physically, spiritually and socially.In general, a person is said to be elderly (Elderly) if he is 65 years old or older.Elderly is not a disease, but an advanced stage of a life process characterized by a decrease in the body's ability to adapt to environmental stress.Aging is a condition characterized by a person's failure to maintain balance against physiological stressful conditions.This failure is related to a decrease in the ability to live as well as an increase in individual sensitivity.The older a person gets, the less the immune system will be (Akha, 2018).This has resulted in an increase in diseases in the elderly, both acute and chronic.
Increasing disorders/diseases in the elderly can cause changes in their quality of life.What is meant by quality of life according to the World Health Organization (WHO) is a person's perception in the context of culture and norms that are in accordance with the place where the person lives and related to goals, expectations, standards and concerns during his or her life.Jamadar, et al. (2015) define quality of life as an individual's sense of well-being that results from feelings of satisfaction and dissatisfaction in areas of life that affect the individual.
Quality of life is a subjective assessment of physical and mental health that is greatly influenced by socioeconomic aspects as well as values and culture around the individual.In line with that, According to Cahya (2017) quality of life is defined as an individual's perception related to their functioning in various areas of life including physical, emotional, functional, and social well-being.Sutikno's Opinion (Tias, 2015) The quality of life of the elderly is a complex component, including life expectancy, satisfaction in life, health and physical function, income, housing conditions, social support and social networks.The quality of life that every elderly person has is different.This is because the quality of life of the elderly implies the level of excellence of a characteristic, where each individual can judge each part of his life differently, so that the quality of life can be different in different individuals.
Posyandu for the elderly is one way to anticipate degenerative changes that occur in the elderly.With the increasing number of the elderly, it is necessary to anticipate because it will have wide implications in the life of families, communities, and the country.Therefore, the elderly need to get an improvement in the type and quality of health services carried out by the elderly themselves as well as their families or other institutions such as the elderly posyandu.The Posyandu for the elderly according to Law No. 13 of 1998 is a forum for services to the elderly in the community that emphasizes health, psychological, spiritual, nutritional services so that the elderly can meet their needs and adequate social welfare Posyandu for the elderly is a program provided by the government, especially the Health Office which is then coordinated by the health center in each sub-district to be further managed and organized by social service organizations or groups community.The managers and cadres in the group come from community participation.
Posyandu for the elderly is a service vehicle for the elderly, carried out from, by, and for the elderly who focus on promotive and preventive services, without neglecting curative and rehabilitative efforts.(Rosyid, et al, 2007).The elderly posyandu is a manifestation of the implementation of development programs from government policies through health services for the elderly, as a communication forum in the form of community participation and social organizations for its implementation, in an effort to improve health optimally.The services carried out by the elderly posyandu are carried out so that the elderly feel appreciated by the people around them and can apply the principle of independence (Self-reliance) so that they are free from dependence.The Kendari City Mekar Health Center has a health officer who handles the elderly posyandu as many as 3 people.Health workers are urgently needed in order to accompany and help the elderly.So that health workers provide services to the elderly as a reference in carrying out assistance, with efforts to improve the quality of life of the elderly.Based on the description above, the research with the title: Elderly Posyandu Services in Improving the Quality of Life of the Elderly at the Mekar Health Center in Kendari City is interesting to be researched.

METHODS
This research has been carried out at the Mekar Health Center on Jl.Laremba Lrg RCTI Kendari, Kadia District, Kendari City, Southeast Sulawesi.The object of the research is the Elderly Posyandu Service in Improving the Quality of Life of the Elderly.Meanwhile, the determination of this location is based on the researcher seeing the characteristics and problems that are relevant to the problem that the researcher wants to research.Researcher The type of data in this study is qualitative descriptive.In this descriptive research analysis, the author analyzes the Services of Posyandu for the Elderly in Improving the Quality of Life of the Elderly.The informants in this study were 7 people, namely 1 nurse, 1 pharmacist, and 1 doctor, and 4 elderly people consisting of 2 women and 2 men.The selection of the informants is based on the consideration that a number of these informants are assumed to be able to provide an overview related to the information needed by the researcher.The selection of informants for this research is determined purposively or deliberately.According to (Sugiyono, 2016) revealed that purposive sampling is a sampling technique of the data source that is considered to know the most about what we expect, or he or she as the ruler so that it will make it easier for researchers to explore the object or social situation being studied.The data collection techniques that will be used in this study are as follows (Sugiyono, 2016) The data in this study were obtained through interviews, observations and documentation studies.
The data analysis technique used in this study, according to Miles and Huberman (Sugiyono, 2016), consists of three streams of activities that occur simultaneously, namely data collection, data reduction, data presentation and drawing conclusions or verification.

Types of Services Provided by the Elderly Posyandu at Mekar Public Health Center in Kendari City
Service is essentially a series of activities, therefore service is a process.As a process, service takes place regularly and continuously, which covers and covers all aspects of human life.Service can basically be defined as the activity of a person, group and/or organization

Health Services
The examination of activities of daily living includes basic activities in life, such as eating/drinking, walking, bathing, dressing, getting on and off the bed, defecating or urinating, and so on to assess the level of independence of the elderly.Blood pressure measurement using a sphygmomanometer and stethoscope as well as a one-minute pulse count.Posyandu for the elderly provides services with the elderly in Posyandu, in this case providing services, assistance, examinations, so the form of health services is that health workers provide complete services and the elderly carry out the rules determined by health workers, for example such as doing tension, scales.

Supplemental Feeding
Supplementary Food (PMT) is one of the important services provided by the Elderly Posyandu at the Mekar Health Center in Kendari City.This program is designed to meet the special nutritional needs of the elderly, who often experience decreased appetite or difficulty in getting enough nutrients from their daily diet.PMTs typically consist of foods rich in protein, vitamins, and minerals, such as mung bean porridge, milk, or other nutritious snacks.
The implementation of PMT at the Posyandu Elderly is not only providing food, but also involves nutrition education to the elderly and their families.Health workers provide an explanation of the importance of balanced nutrition and how to prepare food that suits the needs of the elderly.This aims to increase family awareness and ability to provide the right nutrition for the elderly at home.The effectiveness of the PMT program is monitored through routine checks on the weight and nutritional status of the elderly.Posyandu officers also conduct periodic evaluations to ensure that the type of additional food provided is in accordance with the preferences and needs of the elderly.Thus, the PMT program not only functions as a nutritional supplement, but also as a means to improve the quality of life and welfare of the elderly in the work area of the Mekar Health Center in Kendari City.

Sports Activities
The elderly posyandu services at the Mekar Health Center in Kendari City show a strong commitment to improving the quality of life of the elderly.One prominent form of service is sports activities, which include elderly gymnastics and leisurely walking.These activities are specifically designed to improve the physical fitness of the elderly, which is crucial in maintaining their health and mobility.The implementation of this sports activity not only focuses on the physical aspect, but also has an important social dimension.By holding joint activities, posyandu for the elderly provides opportunities for the elderly to interact with each other, reducing the social isolation that is often experienced by this age group.This social interaction can help improve the mental and emotional health of the elderly.
The role of posyandu officers is very crucial in the implementation of this program.They not only facilitate physical activities, but also provide socialization about the importance of a healthy lifestyle for the elderly.This holistic approach reflects the understanding that the health of the elderly is not only related to physical conditions, but also involves psychosocial aspects.By combining physical activities and socialization, the elderly posyandu at the Mekar Health Center in Kendari City has created a comprehensive service model.This model not only aims to maintain the physical health of the elderly, but also pays attention to their social and emotional well-being.This approach is crucial in ensuring that seniors can live their old age actively, healthily, and happily.
The services of the elderly posyandu at the Mekar Health Center in Kendari City reflect a holistic approach to elderly care that aims to improve their quality of life.One of the main aspects of this service is sports activities that include elderly gymnastics and leisurely walking.These activities are specifically designed to improve the physical fitness of the elderly, which is an important component in maintaining their mobility and physical health.
In addition to the physical benefits, this activity also has a significant social dimension.Social interactions that occur during joint activities can help reduce social isolation that is often experienced by the elderly.This social isolation, if left untreated, can contribute to a decline in mental and emotional health.Therefore, through fun and interactive sports activities, posyandu elderly provides a platform for the elderly to interact, build friendships, and feel part of the community.
The role of posyandu officers is very important in the implementation of this program.
They not only facilitate physical activities but also provide education and socialization about the importance of a healthy lifestyle for the elderly.This education includes knowledge about nutrition, safe physical activity, and tips for maintaining mental and emotional health.By combining physical and psychosocial aspects, the elderly posyandu at the Mekar Health Center in Kendari City has created a comprehensive and holistic service model.This model emphasizes the importance of overall well-being, not just physical health, so that the elderly can enjoy a more qualified, active, healthy, and happy life.This approach is very relevant in the context of an ageing population, where improving the quality of life of the elderly is the main focus of public health services.

Non-Health Activities
The elderly posyandu service at the Mekar Health Center in Kendari City shows a holistic approach in improving the quality of life of the elderly.The non-health activities offered reflect the understanding that the well-being of the elderly is not only limited to the physical aspect, but also includes spiritual, social, and economic dimensions.This is in line with the concept of "active aging" recommended by the World Health Organization (WHO), where the elderly are encouraged to remain active and productive in various aspects of life (WHO, 2020).The spiritual activities provided help meet the spiritual needs of the elderly, which often become increasingly important as they age.Social gatherings and productive economic activities not only provide financial benefits, but also promote social interaction and a sense of usefulness among the elderly.This is in line with the findings of Rosita et al. (2018) which emphasized the importance of social involvement in maintaining the mental health of the elderly.Gardening activities and hobbies provide opportunities for the elderly to stay physically and mentally active.
According to research by Dewi et al. (2019), light physical activity such as gardening can help maintain cognitive function and reduce the risk of dementia in the elderly.
Meanwhile, discussion forums facilitate the exchange of knowledge and experience, which is important for maintaining the mental acuity of the elderly.The careful and caring approach of officers in providing services shows the implementation of the principle of "personcentered care" which is increasingly emphasized in modern geriatric care (Sunaryo et al., 2017).The invitation to refresh reflects an understanding of the importance of varied activities and changes in the environment in maintaining the mental health of the elderly.The effectiveness of this program is supported by research by Utami et al. (2021) which shows that comprehensive elderly posyandu services can significantly improve the quality of life of the elderly.However, continuous evaluation and program adjustments based on the changing needs of the elderly remain important to ensure the relevance and effectiveness of the service in the long term.

Facilities and Infrastructure of Posyandu for the Elderly
The elderly posyandu service at the Mekar Health Center in Kendari City reflects the government's efforts to improve the health and welfare of the elderly.Facilities and infrastructure are critical components in supporting the effectiveness of this service.However, the reality on the ground shows that there is a gap between the efforts of officers and the availability of adequate facilities.Posyandu elderly officers have tried to provide comfortable services, showing their dedication to the welfare of the elderly.This is in line with the research of Sulaeman et al. ( 2018) which emphasized the importance of service quality in increasing the participation of the elderly in posyandu.However, the limited facilities are a significant obstacle in realizing optimal services.
The lack of facilities has an impact on the effectiveness of services, as revealed by Putri et al. (2019) that the availability of adequate facilities and infrastructure is positively correlated with the quality of elderly posyandu services.These limitations can include various aspects, ranging from medical equipment to inadequate service spaces.This situation illustrates the challenges faced in the implementation of public health programs, especially for the elderly population.In accordance with the findings of Ratna et al. (2021), improving elderly posyandu facilities not only improves the quality of services but also encourages the active participation of the elderly in health programs.To address this issue, a comprehensive approach involving various stakeholders is needed.
Increasing the budget for the procurement of facilities, training officers in optimizing existing resources, and innovations in service methods can be potential solutions.In addition, collaboration with the private sector and community organizations can also help in the provision of better facilities and infrastructure.Thus, despite the good efforts of the officers, improving facilities is the key to increasing the effectiveness of elderly posyandu services at the Mekar Health Center in Kendari City.This is important to ensure that the elderly receive quality and comprehensive health services according to their needs.

Supporters of Posyandu Services for the Elderly at the Mekar Health Center, Kendari City
Based on the results of the research conducted, it shows that the supporters of individual health services and public health are affected, namely behavioral factors.Behavioral factors themselves are largely determined by three factors, namely:

Youth Factor (Predisposing Factor)
The youth factor (predisposing factor) plays an important role in supporting the services of the Elderly Posyandu at the Mekar Health Center in Kendari City.These factors include various aspects such as knowledge, education, employment, beliefs, and demographics which include socio-economic, age, gender, and family size.The success of the Elderly Posyandu service is greatly influenced by the positive response given by the youth to the elderly and the understanding they provide about the benefits of the Posyandu.The knowledge and education possessed by youth allows them to provide accurate and easy-to-understand information by the elderly regarding the importance of Posyandu (Pratono and Maharani, 2018).This helps the elderly to better understand the benefits of their participation in Posyandu activities.In addition, the work and socio-economic background of youth also affects the way they communicate and interact with the elderly, which in turn can increase the comfort and trust of the elderly in the services provided.
The beliefs and values embraced by the youth also play a role in motivating the elderly to actively participate in Posyandu activities.With the right and empathetic approach, youth can help overcome psychological barriers that older people may face, such as shyness or selfdoubt due to age factors.Demographic factors, especially age and gender, are not a barrier to the activity of the elderly in Posyandu.This shows that the inclusive approach applied by youth has succeeded in creating a comfortable environment for all the elderly, regardless of their background.The number of families is also not an obstacle, because a good understanding of the benefits of Posyandu makes the elderly remain actively participating.
This success shows that the youth factor has a significant impact in supporting and maintaining effective Posyandu Elderly services.By continuing to improve the quality of this youth factor, it is hoped that the services of the Posyandu for the Elderly will further develop and provide greater benefits for the welfare of the elderly in Kendari City.

Enabling Factor
Enabling factors play an important role in improving the effectiveness of Posyandu Elderly services at the Mekar Health Center in Kendari City.The availability of adequate health facilities and resources, as well as easily accessible locations, are key in encouraging the participation of the elderly.Research shows that health workers are trying to adapt services to the location where the elderly live, making it easier for them to access Posyandu.
This approach is in line with the concept of "age-friendly communities" put forward by the World Health Organization, where accessibility is one of the crucial factors in elderly health services (WHO, 2018).Furthermore, Chen et al. (2019) emphasized that distance and ease of access to health facilities significantly affect the frequency of visits by the elderly for routine health checkups.This service location adjustment strategy also supports the principle of "aging in place", which allows seniors to remain active and involved in their community while receiving necessary health care (Sixsmith et al., 2017).Thus, the efforts of the Elderly Posyandu officers at the Mekar Health Center in Kendari City in providing easily accessible services are a positive step in improving the quality of life and health of the elderly in the region.A supportive community environment also plays an important role in strengthening the participation of the elderly in posyandu.People who have a high awareness of the importance of elderly health can create an atmosphere that encourages and appreciates the participation of the elderly in posyandu activities.A study by Lestari et al. (2018) shows that social support from the community has a positive impact on the quality of life of the elderly and their participation in community health programs.Family support not only provides physical and emotional encouragement, but also creates a positive impression and a feeling of appreciation in the elderly.This can increase the self-esteem and intrinsic motivation of the elderly to maintain their health.

Supporters of
As revealed in the Beard et al. (2016) study, strong social support, especially from the family, correlates with improved mental and physical health in the elderly population.In the context of the Mekar Kendari City Health Center, strengthening these factors can be done through various approaches.For example, by conducting educational programs for families about the importance of their support for the health of the elderly, training for health workers to improve their communication and empathy skills, as well as public awareness campaigns on the important role of elderly posyandu.By optimizing these reinforcing factors, it is hoped that the participation of the elderly in the posyandu program can increase, which in turn will have a positive impact on their overall health and quality of life.

CONCLUSION
Based on the results and discussion above, the conclusion that can be drawn in this study is that the Elderly Posyandu at the Mekar Health Center in Kendari City offers various forms of services to improve the welfare of the elderly.Comprehensive health services are provided according to the needs of the elderly, including routine check-ups.In addition, the posyandu also provides additional food as a form of attention.Sports activities are held to maintain the physical and mental health of the elderly, as well as facilitate social interaction.
To avoid boredom, posyandu holds non-health activities such as holidays.Adequate facilities and infrastructure are also provided to support all these activities.The success of this program is supported by several factors.The elderly's understanding of the benefits of posyandu is very good thanks to effective socialization from health workers.The location of the posyandu spread across several points makes it easy to access for the elderly.No less important is the support from the people around them, which plays a crucial role in creating a sense of comfort and happiness for the elderly, as well as being a determining factor in realizing the welfare of the elderly.
either directly or indirectly to meet needs.Based on the Regulation of the Ministry of Health of the Republic of Indonesia No. 67 of 2015 concerning the Implementation of Elderly Health Services in Community Health Centers, the types of services provided to the elderly at posyandu include the following: According to "Health Promotion and Aging: Practical Applications for Health Professionals" byDavid Haber (7th edition, 2016), continuous health education can improve the elderly's understanding of the importance of maintaining health and encourage them to actively participate in maintaining their well-being.In addition, "Successful Aging: A Neuroscientist Explores the Power and Potential of Our Lives" by Daniel J.Levitin (2018) mentions that regular physical activity, such as those carried out in elderly posyandu, can help maintain cognitive function and slow down mental aging.Furthermore, the book "Aging and Mental Health" by Daniel L.Segal, Sara Honn Qualls, and Michael A. Smyer (2018)  highlights the importance of social support in maintaining the mental health of the elderly.In this context, the activities facilitated by the elderly posyandu not only offer opportunities to exercise, but also to get emotional support from fellow elderly people and health workers.
Posyandu Elderly Services at the Mekar Health Center in Kendari City play an important role in improving the health and welfare of the elderly.Reinforcing factors that include family, attitudes of health workers, and the community environment are crucial elements in encouraging the participation of the elderly in posyandu.Among these factors, family support has a very significant role.The family is the closest social unit for the elderly and has a great influence on their health behavior.Family support that is active in encouraging the elderly to visit the posyandu can increase their motivation and consistency of participation.This is in line with research conducted byRosyid et al. (2019) which shows that family support is positively correlated with the activeness of the elderly in participating in posyandu activities.Families not only play a role in providing moral encouragement, but can also help in practical matters such as escorting the elderly to posyandu or reminding them of visiting schedules.In addition, the positive and empathetic attitude of health workers is also a significant strengthening factor.Health workers who are friendly, patient, and understand the special needs of the elderly can create a comfortable and supportive environment at the posyandu.This is supported by a study byKholifah et al. (2016) which emphasizes the importance of effective communication and positive attitudes of health workers in increasing satisfaction and compliance with health services.