Ageing is a universal phenomenon. With advanced medical facilities available even in smaller towns and the rapid strides in the management of chronic illnesses, people are now living longer with more diseases. While there has been a drastic shift in medical field and the accessibility to quality care, there has been a dramatic change in the family and societal structure of the Indian community. Urbanization, migration to bigger cities and adoption of nuclear family structure has deprived us of the traditional caregivers- usually family members, who used to take of the sick and needy in the family.
While ageing itself poses significant challenge to the elderly, the fact that there is no focused health care delivery system catering to the unique needs of the elderly is the biggest challenge the elderly cohort is facing now. Coimbatore is considered as a preferred destination for elderly from rest of Tamil Nadu and adjacent states to come and settle. While climate and low cost of living makes Coimbatore a preferred destination, our medical sector isn’t geared up to meet the increased health demand. While there are some positive momentum in this aspect after specialized elder-care clinics ( Grand World Elder Care) started operating in Coimbatore, the onus is still on the elderly is to keep themselves healthy and active in the community.
The state of wellness, defined as the state of subjective happiness unrelated to absence of disease, very much defines the philosophy of ‘ageing well’. A holistic approach to health, wellness and life sets the stage for graceful ageing. The preparation for such a lifestyle should begin early in life- the sooner, the better. While the aim is to balance all the dimensions of wellness together, the ageing process itself can disturb this delicate balance. Effort should be made to optimize the compromised function and enhance the functions which can contribute to overall well-being.
For easy understanding of what these dimension are, they have been conveniently divided into 7 – physical, emotional, spiritual, vocational, social, environmental and intellectual. Each dimension is as important as the other, each having its own identify yet able to compensate and accommodate others too. Let us see in brief what these dimensions mean and how you can work on each dimension.
- Keep an eye on your health- Keep your blood pressure, sugar, cholesterol, body weight under control. Visit your physician regularly. Don’t compromise on health monitoring. Remember you save money if you keep your diseases under check.
- Keep Moving-Walk 45 minutes daily at a speed comfortable to you. 45 minutes needn’t be at a stretch. Take rest in between if you are tired, breathless or have pain.
- Strengthen the muscles- Do at least 20 minutes of muscle strengthening and balance exercises daily. Chair exercises, yoga, Tai Chi are good ways to keep you away from falling. Talk to a physiotherapist regarding exercises which are best for you.
- Sleep well- 6 hours of uninterrupted sleep is what you require to reboot your brain. Avoid taking sleeping pills- a glass of warm milk will do the trick. For those who wake up at night quite often to pass urine, follow some of these tips- reduce water or any fluid intake after 4 in the evening, pass urine before going to bed, avoid caffeinated drink like tea or coffee after 4 in the evening. You may also ask your doctor whether any of the pills you take causes excess urination.
The process of ageing itself can cause emotional turmoil. Adjustment disorders due to the physical changes and disabilities are very often seen. Taking ageing process as a natural way of life and moreover, adapting and accepting change, is important. Death of spouse, bereavement, depression, adjustment disorder, loneliness and grief are common emotional problems that elderly face.
- Talk and Listen- Talking to your friends about the emotions is one good way of venting. Most often men find it feminine to talk about emotions, which make providing help difficult. Counselling services, support groups and group therapies are effective channels to support your emotions. A good counsellor can guide you through difficult time and be a good friend
- Stay Social- Involve in social groups, resident associations, self-help groups, and bhajan and prayer groups.
- Volunteer and help- Get involved in volunteer activity. You can volunteer to take care of sick friends at hospitals rather than sit at home and brood over unnecessary things. Help a disabled neighbor with groceries or paying bill. Helping another person brings gratification which is effective in building positive energy around you.
Memory impairment, confusion, slowness of thoughts and actions are common impairments of intelligence that happens as you age. Though age related changes occur in brain and can manifest as memory impairment, not all memory impairment are age related. Dementia is a medical syndrome that needs to be carefully evaluated by an elder care specialist. Effective intervention in early stages along with behavioral and lifestyle adaptations can help makes things much easier for you and your family.
- Keep yourself updated- read newspaper and books, involve in discussion about current events among your friends (without fighting!), write or pen down your thoughts.
- Play- Involve in mentally stimulating games- crosswords, Monopoly, Sudoku, Pictionary which you can play with your spouse or friends. Make playing such games part of daily routines. Chess, bridge card games and Chinese checkers are also effective.
- Do something new- learn a new language, explore new places, visit your children staying away (keep the visit short and sweet), watch movies, and try to appreciate new types of music. These activities keep your brain stimulated.
The general trend among the elderly is to retire and forget work. Physical inactivity along with mental inertia is a serious cocktail for diseases.
- You needn’t stop working- You can still continue doing the same job you were doing or explore things which you always wanted to do. Elderly can take up their hobbies seriously like painting, music, gardening or playing an instrument.
- Teach a skill you possess to some who doesn’t.
- Learn computers or start using newer technologies like smart phone.
Almost all the public utility facilities and the space that we create at home and office are built for people much younger. The disability that accompanies ageing such as joint problems, falls, immobility and confusion can cause harm at home and outside. How we modify these threatening environments to suit our needs is key to safety.
- Keep your room clutter free. Tape down carpets and mats.
- Ensure adequate lighting in your rooms, stairs and pathways, especially the pathway to the toilet
- Skid free tiles are a good options if you have the budget to change the tiles
- Most of the accidents happen in the toilet or on the way to toilet. Have side bars and hand bars installed at appropriate spaces. A toilet seat raiser should be used for people having trouble getting up from western commode. Hand shower is the preferred way of taking shower.
- For elderly having high chances of fall, keep the toilet door unlatched or use a 2 way latch lock.
- Wear proper footwear while going out.
- Involve in community activities- neighborhood self-help groups, volunteer services and NGO’s
- Be part of clubs or form a club
- Take time to visit a bed bound or home bound friend.
- For women, especially, these groups and clubs act as buffer against loneliness and monotony.
- Being social is a good channel to guide your thoughts and improve your overall well-being.
- Connect through technology with friends staying away or family staying abroad.
The spiritual needs of people vary from person to person. While some use religion as the means to satisfy their spiritual needs, some find volunteering or helping others as their means. Spirituality has great healing powers and can be an effective tool in guiding you through the ageing process. Meditation is a good way to relax and calm down.
Ageing is all about balancing the dimensions. Seek timely help and never ignore any signs attributing it to ageing body. Wish you all a wonderful journey!
Dr Rahul Padmanabhan is a Clinical Gerontologist and Wellness Consultant, with vast experience in elder-care. His interest includes community geriatrics and dementia care. He is currently the Medical Director for Grand World Elder Care Clinics, Coimbatore. He can be contacted through firstname.lastname@example.org or visit any of the Grand World Elder Care Clinics ( 76677-11111)