Latest Social issues

Senior Citizens: Living a healthy and happy life

(Guidelines/ suggestions for senior citizens and care takers)*

The average life expectancy of people in India has improved significantlyin the last few decades; growing to around 68 years. Presently in India there are nearly 104 million elderly persons (aged above 60 Years). Out of this over 53 million are females and 51 million males. Increase in average life expectancy means that people are living for longer time and hence there has been a substantial increase both in the proportion and total number of elderly people .This is due toa combination of various factors like education, economic conditions ,more awareness about health issues and self caring, advancement in medical techniques and facilities and availing these facilities, desire to live and enjoy life after retirement/ or working for long years , improved nutrition, hygienic and better sanitation , enhanced economic conditions , and due to other social cultural factors . A number of initiatives taken by the government and voluntary sectors have also contributed in this.

Challenges faced are different for people who live either in joint families(with their children ) , who live separately /independently or those who live in old age homes or with some relatives or friends.A number of issues are emerging with the times that needs to looked into liketheir safety and security , facilities and infrastructure for theirmobility , occupancy with some constructive work .Creating work situations for senior citizens, both male and females, of various economic strata as per their experience and capacity is urgently required . All aspects of health ( physical, mental, and emotional) also need to be addressed.

What Is the Need Of The Hour?

By this age, usually there are changes in the family composition .These changes occur according to the type of communities, family traditions and circumstances. The family composition can be any of the following:

Married people having adult children and who are living with them in their house.
Married people having adult children but they have left homes/ not living with them due to jobs or any other reason.
Senior citizens who don’t have children and are living independently.
People who are living alone.
Senior citizens living in their children’s house.

The mostcommon challenges faced by the senior citizens are insecurity , irritability , lack of mobility , loneliness, feeling left out , hopelessness, self pity ,poor or deteriorating health , difficulty in chewing and digesting all types of food , lack of interest in life , lack of stamina and motivation , lack of initiative and enthusiasm and increased sensitiveness to situations.

Discouragement and neglect by the people, relatives, society, family members’ is also sometimes a strong contributing factor for above situations.

Objective:

Enable Senior citizens to have a healthy and graceful life, the aim should be that they;

Develop confidence, self respect, and self esteem.
Have good physical and mental health (mental alertness, physical fitness, mobility).
Be provided with a safe and secure environment.
Be busy in constructive engagements.
Be Independent, should be able to take care of oneself as long as possible.
Are self motivated as well as act like a motivator to others?
Have some purpose in life (however small it may be).
Doing some social service/ contributing to the society.
Try to avoid rigidity and start thinking positively ….. Yes something new and useful can be tried

But to achieve the above objectives, overexertion and over enthusiasm should be avoided as this may be counterproductive. Practical approach should be followed and whatever is possible should be done.

If senior citizens feel unsafe they should inform relatives / police

Life Style Changes That May Help;

First and foremost is to have a positive attitude towards life. Life becomes easier.
Living in past does not serve any purpose, try to move with time, see and enjoy new things coming in life. Be thankful to utilize new opportunities and to learning new things.
Do few things that you have missed out in life when you were young (if health and circumstances permits) and others to keep you fit, healthy and happy.
Have a good regular routine; taking nutritious food as per the body requirement, taking adequate rest and sleep. Sleeping and getting up at right time is must for a healthy life.
Maintaining personal hygiene.Never avoid natures call.
Wearing comfortable clothes as per climatic conditions.

Everyperson has different experiences in her / his personal life .Working experiences also varies. Personality traits differ; some people are introvert, some are extrovert, some like to work independently others in groups, some are good at managing and organizing things others like to do themselves, some like to travel while others don’t like too much moving around. Some people like talking /meeting people and gossiping while others are quite and like to work silently. Keeping these factors in mind activities from the following may be taken up.

Activities / tasks that may be taken by the senior citizens

Try to keep constructively busy to avoid boredom.

To avoid loneliness, depression and anxiety, remaining in regular contact with their friends, relatives and colleagues may help. Try to be more tuned in to their environment and keeptheir close people well informed about various issues related to their well being, safety and security. Casual interaction with their reliable and verified helps can reduce boredom.
Act like Motivatorfor others.
Kitchen related tasks like, sorting, cleaning vegetables. If health permits they can also prepare quick and simple recipes (keeping safety factor in mind).
Activities that are less strenuous like light cleaning, dusting, making and their own beds, arrangingrooms, things etc can be undertaken.
Washing small clothes / or arranging for washing machines, keeping clothes at their own place.
Playing indoor games like chess, carom board, cards, snake sand ladder puzzle, word building, antakshari .
Playing outside sports like badminton, swimming classes specially designed for elderly participants.
Arts and crafts ;painting , making gift envelopes , gift bags , wall hangings, small boxes for gifts made out of card boards ,
Photography; still and video.
Net searching for good and useful information to update own knowledge as well to disseminate among others.
Working with nature; gardening (watering plants) arranging indoor plants.
Observing birds and animals and documenting their interesting and unusual behavior and sharing it with other people.
Listening music ; old filmy songs , new songs , bhajans , classical songs , western songs ,
Keeping Pet ( dog , cat , fish , hen/cock ); again depending upon the capacity, space , funds and support available .
Banking ; Learning internet, new features in computers and mobiles and other electronic gadgets ,
Performing arts; learning vocal / instrumental music, Indian classical, western, light, folk and filmy songs, regional songs and bhajans. can also try learning dances ; Indian folk and western as well as of other countries. Creating own tunes and songs.
Outings and trips, visiting different places, picnics , relatives, friends, botanical gardens, historical/ monuments, Visiting same places those were visited or lived during childhood and comparing earlier with present situations.
Health and fitness: doing simple yoga, breathing exercises, walking.
Writing down own positive life experiences for community magazines , blogs newspapers and magazines , writing story books for young children.
Drawing and paintings , making wall hanging , fabric painting on handkerchief , napkins, pillow covers , towels, table mats ,and on paper bags for gifts.
Sewing by machines or hand, simple and straight clothes like small cloth bags. Mending clothes
Needle work ,Crochet (kirochia),Knitting ,
Embroidery with simple stitches (hand embroidery , machine embroidery )
Designing on hand and feet like Heena putting/ applying , tattooing.
Water coloring, fabric painting, and glass painting.
Fresh and Dryflower arrangements at home.
Listening to Radio…. News, songs, discussions, information on current affairs.
Watching Television ; serials , news , discussions on current topics discovery channels , cooking recipes , historical programme, dance , drama .
Decorations at home particularly during festivals, wall and floor decorations.
Preparing traditional and new recipes and passing this information to friends and younger generation .
Taking care of grand children for sometime/ occasionally as per energy, stamina, time and circumstances.
Attending social functions, birthdays, marriages, and other celebrations .Participating in kitty parties, senior citizens forum.
Organizing/ participating sports meet mela etc.
Theatre /Movie watching.
Community service; working with some voluntary organization; organizing donations for needy, collect clothes, toys, utensils and other household items.
Remaining in touch and Coordinating with people in a peaceful and healthy way
Joining / participating in community awareness programmes/ drives; Creating awareness about global warming , recycling , sanitation and cleanliness , pollution , or any other health and nutrition or any emerging issue related to society .
Participating in music concerts , dramatization ,
Voluntary administrative work in hospitals, blood banks, schools and other establishments.
Planting and taking care of nearby gardens, plants and trees.
Helping in simpleactivities in nearby religious places.

Activities should be undertaken keeping in mind all the aspects like capacity and circumstances. Above list is mainly for the urban population and is not exhaustive. More activities can be thought of according the situations.

Diet care to be considered for older people:

It is a well known fact that by the time one reaches adulthood, body growth, particularly in terms of height and weight stops. However, what is not obvious to the outside world is that the wear and tear of the human body continues. This means that the body still requires adequate food sources to repair body tissues continuously and to maintain this function the human body requires adequate amount of all the nutrients. The elderly need to make sure that they have both proper and adequate nutrition so that they do not unnecessarily have diet related issues at this stage of life. Needless to say any diet related issues will have a serious impact on their health.

Before dealing with the nutritional requirements of adults and old people, it is important that we understand some critical points regarding food. The main functions of the food are to provide energy and to maintain growth and repair of the body and protecting the body against diseases.

The basic nutrients of the food are carbohydrates, protein, fat, vitamins and minerals. Vitamins can be subdivided into two categories; (a) water soluble -which includes Thiamine, Riboflavin, vitamin B6, and Vitamin C, and (b) fat soluble - which includes Vitamin A, D, K and E. Minerals include Iron, Iodine, Calcium and Phosphorous and many other trace elements like Zinc.

The food groups can be divided into mainly three categories as per their functions. These are

Foods for energy like staple food (rice, wheat, jowarbajara), roots and tubers, jaggery and sugars and fats and oils.
Foods for growth and maintenance like pulses/legumes, peas and beans, nuts and other dry fruits, milk and milk products, and eggs , meat, fish and chicken.
Foods for proper functioning and protection against diseases. These include milk and milk products, leafy and yellow and colorful fruits and vegetables, meat, eggs and fish.

The nutritional requirements are different for every person and requirements are dependent on number of factors including –

Age, Sex of the person, Activity levels ,Body Weight, Height and Composition (the body physique) ,Climatic Conditions ,Body growth/Breakdown and repair of body tissues ,Physiological stress.

In the case of adults, nutritional requirements for the men and women differ mainly due to difference in body weight and body composition and are not directly related to gender except requirements of nutrients like Iron which is required more in women until menopause. It is clear that at different stages of our life, our food requirements change. Before planning diets for the older people it is necessary to keep in mind, the factors which are associated with the aging. These include; Physiologicalchanges ,Loss of teeth ,Decreased neuromuscular coordination ,Impaired hearing and failing vision ,Diminished sense of taste and smell ,Physical discomfort ,Changes in body composition ,Changes in gastrointestinal tract ,Changes in cardiovascular system ,Changes in respiratory system ,Changes in renal function ,Changes in skeletal tissues ,Hormonal changes,Socio psychological change , and change in Food habits with time .

Above changes cause a number of health issues for elderly people including obesity, under nutrition and malnutrition, osteoporosis, high blood pressure , cardiovascular diseases and diabetes.

To manage the health of the elderly ;

It is critical that not only do they take nutritious and balanced diet, they should go through medical checkups at regular intervals.
Take medicines/supplements regularly, if prescribed by the doctor.
Go for walk/stroll , light physical exercises , yoga , as per their capacity to keep their body moving and to avoid sedentary life style .
Avoid under or overeating. Take meals at a regular time.
Care should be taken that none of the meals is missed out.
Food should be chewed properly.
Take suggestions from time to time on modification of diet as per health requirements from doctor / dietician.
To maintain good health, diets should include all the nutrients in required amounts.
Liberal amount of milk and milk products (unprocessed) should be included.( unless advised otherwise by the doctor )
Intake of simple sugars and energy rich foods like sweets and ice-creams, fried or high fat foods, cereals and starches should be reduced as energy requirements of elderly people are quite low.
Fresh and seasonal fruits and vegetables particularly green leafy vegetables should be included to meet the vitamin and mineral needs. But care should be taken that vegetables and fruits are washed and vegetables are cooked properly.
As in the aged people, constipation, diabetes and cardiovascular diseases are quite common .Therefore adequate amount of foods rich in dietary fiber should be included. Whole cereal dahlia /porridge/ whole cereal bread and biscuits rich in fiber can be part of their snacks /breakfast.
Food should be modified and as far as possible, variety may be provided. Food should be colorful, attractive and tasty .
Food should be served in pleasant and relaxed atmosphere and surroundings so as to arouse their appetite and interest in food.
Drink plenty of water ( in normal cases otherwise consult doctor in case of any health issue).
Minimum uses of processed foods as these are rich in salt, sugar and fats.
Include micronutrients rich foods in diet.
Listen to your body …. Many times, it gives indications of coming illnesses.

A number of initiatives have been taken up by the Governments for senior citizen’s population, depending upon their economic and other criteria. Some of these are pension, medical facilities, discounts /rebate in travelling, and police support. The Resident Welfare Associations, Senior Citizens Welfare Associations formulated at various places are also working for the welfare of the senior citizens. Some of the activities taken up by them are celebrating festivals, organizing picnics and outings both within the city or outsides, taking them to movies and other entertainment places and organizing camps for health checkups. Several voluntary organizations are also working for betterment of senior citizens. Opening old age homes, Day care center, clubs/ entertainment center, arranging for transport to visit hospitals or to other places, health checkups at home are some of them.

* Nirmal Tikku, Ex Deputy Director, NIPCCD , New Delhi, INDIA