Saturday 10 February 2018

The Art of Ageing

Here I am going to summarize the topic on "Art of ageing" written by Dr Rahul Padmanabhan in which he highlights about 7 types of dimensions and it's importance along with the dependence of each dimension on to the other. As we are aware ageing is a natural and the advancement in the medical field has ensured that people live longer even though they are affected with more diseases. But this alone doesn't supports people during their days of ageing, something important than this has been lost today is the support of the family members due to the adoption of nuclear family structure. It has brought about a drastic change in the family and societal structure of the Indian community. So elderly people of today's society are in need of a health care delivery system that can that satisfy their unique needs which has always been a challenge. I can share a case study from my experience is that today many youngster's feels that they can lead a comfortable life abroad living behind their aged parents in an old age home thinking that they get the best care over there but that is something not expected by them (parents). Only thing they expect is the affection of their children during their course of ageing as that gives the needed energy which no medicine can give them.  
Here the author has highlighted that Coimbatore is a better destination for the elderly people in terms of climate and cost of living even though the medical sector isn't geared up to meet the increased health demand. They have started a specialized elder care clinic Grand world elder care  which has shown some positive momentum since it's operation at Coimbatore.  Author highlights that the preparation for the lifestyle which will be lead during the course of ageing should begin earlier and it will be smooth only when we adopt a holistic approach to health, wellness and life. Aim should be on balancing the highlighted dimension together which might get disturbed by ageing process itself. Efforts needs to be made in order to optimize the compromised function and enhance the functions which can contribute to over well-being.
Let us see in brief about each dimension suggested by the author Dr. Rahul Padmanabhan

Physical Dimension

1. Keep an eye on your health - Visit physician regularly and  have a regular health checkup done against blood pressure, sugar, cholesterol, body weight under control. Don't compromise on health monitoring.
2. Keep moving - Walk 45 minutes daily at the speed comfortable to you. It need not be continuous 45 minutes at a stretch. Take rest in between when you are tired, breathless or have pain.
3. Strengthen your muscles - Perform certain exercises like yoga, chair exercise, Tai Chi for 20 minutes in order to strengthen the muscles which can prevent you from falling. Also physiotherapist exercises which are best for you.
4. Sleep well - 6 hours of uninterrupted sleep is required to reboot your brain. Avoid taking sleeping pills which can be replaced with a glass of warn milk. If you get up in the night for urine, fluid intake can be reduced after 4 in the evening along with avoid caffeinated drinks like Tea or coffee. Doctor can be consulted against the pills which you intake that might cause excess urination.

Emotional 

1. Talk & Listen - Talking to your friends about the emotions is one good way of venting. Likewise other approaches like counseling services, support group and group therapies are effective channels to support your emotions. A good counselor can assist in overcoming the difficult time and be a good friend.
2. Stay Social - Involve in social group, resident associations, self-help group, and bhajans and prayer groups
3. Volunteer and help - Volunteering oneself by assisting other sick friends at hospital instead of being idle at home and brood over unnecessary things. Helping other person brings gratification which is effective in building positive energy around you.

Let me give an example, let us take people from villages & town where after the completion of their daily routine they get involved in speaking with their friends on the sit out place in Tamil we call vasha tinnai which was there is every houses of our brahmin community where they speak about their difficulties for which they get a resolution which gives them a little people of mind where no counselors like today existed. They do some volunteer services for temples festival or temple administrations which keeps them active in those activities. Benefit reaped out of it is keeping their mind away from personal activities or difficulties for certain time frame.

Intellectual

Memory impairment, confusion, slowness of thoughts and actions are common impairment that happens as you age. In which all the memory impairments are not related to age like Dementia which needs to be carefully evaluated by an elder care specialist. Effective intervention in early stages along with behavioral and lifestyle adaption can help makes things much easier for you and your family.
1. Keep your updated - read newspapers and books, involves in discussion about current events among your friends, write or pen down your thoughts
2. Play - You can play games like chess, bridge card games and Chinese checkers. Make playing such games part of daily routines
3. Do something new - Activities like learning new languages, explore new places, visit your children staying away (Keep the visit short and sweet), watch movies and try appreciating new types of musics which keeps the brain stimulated

A generation back I have seen many elders engaged in the above activities which passes away certain time and also keep them updated. Let us take Kalam Sir for this as he was not only scientist but also engaged most his time in teaching, mentoring children to dream big for the country and talented in veena made him to spend his usefully without giving thoughts on unwanted politics which made him to keep his memory active until his last breath which ended while starting his speech. Likewise there were many elderly people who have been an example for the next generation which today has been lost because they are been kept away and not much engaged in the activities of their own family which are been telecast over internet which has personal sentiments. I have seen my grandfather being happy staying with us had applied the above points always until his last breath.

Vocational

Normally elderly people generally wants to retire and forget work. Physical inactivity along with mental inertial is a serious cocktail for diseases.
1. You needn't stop working - You can still continue doing the same job you were doing or explore things which always wanted to do which includes the hobbies like painting, music, gardening or playing an instrument.
2. Teach a skill which you possess to someone who doesn't
3. Learn computers or start using newer technologies like smart phone

When he/she is good in teaching or art oriented always try to engage themselves in taking classes at their home itself which themselves and their skill active for that limited time frame. When the knowledge is shared it gives the immense pleasure that our skill sets are now passed on to the next generation and also gives the additional happiness when they achieve through that. Let us take an example of Musician DK Pattammal there is a real time story of how she thought  music to people even at that old age like Sai Madhana Mohan Kumar who showed interest towards music. What she got in return is different from the satisfaction she got in teaching those student who showed real interest in learning that skill from her. Many elderly people keep exploring in their skill or passion which keep themselves away from thinking of tough times of old age.

Environmental

As we become aged certain ailments like joint problems, falls, immobility and confusion accompanies which can cause harm at home and outside while using public utility facilities and the space which is normally designed for younger people. How can this customized these threatening environment as per our comfort and safety in order to avoid the risk of getting injured.

1. Keep your room clutter free. Tape down carpets and mats.
2. Ensure adequate lighting in your room, stairs and pathways, especially the pathway to the toilet.
3. Skid free tiles are a good options if you have the budget to change the tiles
4. Most accidents happens 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 for having trouble getting up from western commode. Hand shower is the preferred way of taking shower
5. For elderly people having high chances of fall, keep the toilet door unlatched or use a 2 way latch lock.
6. Wear proper footwear while going out.

Olden days, elderly people were cared by everyone in their house and villagers which is now no more exist. All these are getting replaced with old age homes and remodeling houses in such a way that keeps their aged parent safe. When a man stays in the same house until his death is comfortable with every section of the house and additionally when people are around he/she is confident or else looses the confidence level which is bringing in the above points in places. Of course today we needs to accept these above points as the lifestyle is moving towards nuclear family which is excluding the parents who have give the sophisticated life for their children. 

Social

1. Involve in community activities-neighborhood self help groups, volunteer services and NGO's.
2. Be part of clubs or form a club.
3. Take time to visit bed bound or house bound friends
4. For women, especially these groups and club act as buffer against loneliness and monotony.
5. Being social is a good channel to guide your thoughts and improve your overall well being.
6. Connect through technology with friends staying away or family staying abroad.

Today the old age homes are built in this concepts but it will be completely a new environment when they are moved away from their native place. Anyone will be comfortable in the place he/she has lived for more years will not be able to adapt to the new environment. The above points can be seen in the native places where everyone is known, aware of each and everyone's issues which they can't share easily in old age homes as they are not close as they are with someone who is known from childhood days. I have seen many people saying that when they are in their hometown they are energetic with the routine activities except that they miss their children. Always when wife or husband passes away it is like loosing a support stick as a reliable source for sharing ones difficulty is no more exist which needs to be overcome by above points which is difficult but have to use our skill set which can assist us in doing above thing like someone would be good in teaching, painting, engineering works they will share that knowledge in the group, volunteer service keeps them engaged in those thoughts.

Spiritual

Spiritual needs vary from person to person like some use religion as a means to satisfy their spiritual needs, some find volunteering or help 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.

Let me give an example from a real time experience, I stayed in CBD Belapur, Navi Mumbai. Near my house there was a Ram Temple where everyday many elderly people from old age home "Narmadaben Charitable Foundation (NCF) - Home" which was just operating opposite to the temple used to take part in daily arthi to the lord, spend time cutting coconuts for prasad, listen to the discourses of Ramayana which was delivered by the temple priest. Likewise we can see in Gurudwara's many people irrespective of age group carry out volunteer services which engages in them in the thought of almighty forgetting their tough times. Lot of spiritual discourses and musical seasons are conducted in Tamil Nadu which not gives the knowledge but also takes them close to God if it is rendered by someone like Sringeri Bharathi Theertha Mahaswamigal, Balaji Bhagavathar who is an experts in abhangs which is delivered in local language in such a fashion that we can experience the presence of Lord Vittala and Rukmani. Likewise we have many such experts in spiritual teaching. A generation back many people engage themselves in many spiritual activities to keep them mentally active even though they have a lot of personal problems.
Ageing is all about balancing the dimensions. Seek timely help and never ignore any signs attributing it to ageing body.

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