July 2017 Volume 4 Issue 2 ODISHA JOURNAL OF SOCIAL SCIENCE A Bi-Annual Research Journal (English)
Members of Advisory Board: Chief Editor: Dr. Santa Misra (India) Prof.. Alan D. Scott, (USA) Co-Editor : Prof. Ryo Takahashi (Japan) Prof. Mieke O.Mandagi (Indoneia) Honorary Editor: Prof Irina Pervova (Russia) Prof. Jung-Nim Kim (Japan) Reviewer : Prof. Michael C. Sturman, Prof. Nibedita Jena (India) Ithaca, New York Prof. Mridula Srivastava (India) Prof. Raquel R. Smith, USA Prof. A. Anjum (India) Dr. Haresh Chandra Mishra (India) Dr. Laxmi Rani (India) Special Consultant : Prof. Banamali Mohanty (India) Dr. Harapriya Kar (India) Dr. B. P. Rath (India) Dr. Mamata Mahapatra (India) Dr. Jyotimaya Satpathy (India) Dr. Jyotiprakash Pani (India) Hardaman Singh (India) Contents Sl. No. Topic Author Pg. No. 1. Introduction to A New Scientific Discipline: Management of Jaeyoon Rhee 4 AllSelve's Enlightenment and Empowerment(MOSEE) and Creation Management based on Korean Cultural Technology, Hong-Ik Prosperity and Peace(Methodologies of 366 Virtues of Human Being) 2. Gerontology: Communication Disorder Jaya Sankar Panda 8 3. State of livelihood capitals in rural india: Sasmita Ojha 16 A concern towards its development Bishnuprasad Mohapatra 4. A Study of Changing Social Structure on Dr Arpita Roy 25 The mental Health of The Aged in Ranchi Town Nina Piyali Gupta 5. Factors Predictive of Preferred Place of Nursing Home for Prof. Jung-Nim Kim 32 End-of-Care and Death in Community-dwelling Family Care givers of Frail Elderly in East Asia 6. Behavioural assessment and skill training of two children with intellectual disability Binaya Bhusan Mohapatra 45 7. Problems of behaviour management of children with intellectual disability- a student of chetana institute for the mentally handicapped, bhubaneswar Bichitrananda Swain 52 8. Sharing experiences of elderly Divi Tara 59 Ininstitutionalised care settings: A qualitative study Dr.MamataMahapatra 9. Parenting style and criminal tendency among adolescents Cyma Anjum 75 10. Geriatric problems of adjustment A.Anjum 78 Laxmi Rani, Ranjeet Kumar 11. Aging: Advantages, Issues and Challenges Irina L. Pervova 82 12. TPR® as a tool for CBT Sajeev Nair 85 13. Critical Issues of Teacher Education: Problems and Achievements MD. Osama 88 14. Gerontology is My Life and Your Life Japan Hokkaido Ryo Takahashi 95 Kitami 2020 Vision with Philosophy of Applied Gerontology 15 The Bhagavad Gitā and Health Management of Psychotherapy Surya Narayan Panda 106 DECLARATION
1. Title of the Journal : ODISHA JOURNAL OF SOCIAL SCIENCE 2. Language in which it is published : English 3. Periodicity of Publication : Half-yearly 4. Publisher’s Name, Nationality & Address : Dr. Santa Misra Reader & Head, Department of Psychology Sri Satya Sai College for Women Bhubaneswar - 751030 ODISHA (INDIA) 5. Place of Publication : 2624/3484, Baragada Canal Colony, At/Po.- BJB Nagar Bhubaneswar - 751014 ODISHA (INDIA) 6. Printer’s Name Nationality & Address : SR Creation, 1189, Nilakantha Nagar, Nayapalli, Bhubaneswar-12 Odisha (INDIA) 7. Chief Editor’s Name, Nationality & Address : Dr. Santa Misra Reader & Head, Department of Psychology Sri Satya Sai College for Women Bhubaneswar - 751030 ODISHA (INDIA) 8. Owner’s Name : Dr. Santa Misra 2624/3484, Baragada Canal Colony, At/Po.- BJB Nagar Bhubaneswar - 751014 ODISHA (INDIA) I, Santa Misra, hereby declare that the particulars given above are true to the best of my knowledge and belief.
31st July 201 7 (Santa Misra) Publisher Editorial It is observed that increasing number of worldwide age old population and their effects on society are having striking phenomena of recent research in Gerontology and Geriatrics. Demographical data projected the number of world population aged sixty years and above , increased about 10 % in 2000, will be increased to 13 % by 2020 and 20 % by 2050.This process of aging varies from country to country , But it is certain that the older people are getting more old day by day. The people above 80 years are found to be increased nearly 6 times between 2000 and 2050, Out of which nearly two thirds of the oldest old will be women. Further, although the proportions aged 60 years or over are substantially higher at present in the more developed countries, their numbers and proportions are currently increasing more rapidly in the less developed countries. By 2050, the number of persons aged 60 years or over in the less developed countries is projected to be 4 times as large as it was in 2000; while in the more developed countries, it will be only 1.7 times. The over-80 population of the more developed regions is projected to be 3 times as large by then, but in the less developed countries, it will be as large as 8 times. Hence, this demographic transformation is of much greater concern for the less developed countries. Further, it is more important to note that this demographic transformation is not occurring in isolation. It is embedded in social, cultural, psychological and economic contexts that are also changing and changing in ways that tend to erode or at least unsettle traditional relationships between the generations. The most significantly affected among such traditions are those regarding lifelong co- residence as a basic means of providing mutual support of younger and older adults. Yet, the understanding of the actual living conditions of the older population remains poor, especially in the developing world. Even a basic statistical description of the current living arrangements of older people, and of how those arrangements affect their well-being, has not been carried out for many countries. Over the last twenty-five years, there has been a growing emphasis in the field of gerontology to examine issues related to diversity across racial, cultural and ethnic groups. Odisha Journal of social sciences focusing on the behavioral, psycho-social, and cultural aspects of aging. Understanding the lifespan contributors to aging is also critical as we are experiencing a ‘gerontological explosion’ of adults all across the world. Some articles of this publication are also devoted to understanding this perspective of ageing. To fully understand the contributions of older adults and to appreciate the subject of aging, there must be a commitment to create a multidisciplinary overview of the aging process across diverse groups of individuals, taking into account race, ethnicity, socio-economic status, gender, etc. Recognizing the enormity of this challenge, leaders in the field of gerontology are now contributing to our knowledge and insight on matters most pertinent to understand the changing demographic structure of the older adult population. This effort has resulted in a progressive and multidisciplinary compendium of research pertaining to aging among populations. The current publication of this journal has also included some research articles combining multidisciplinary approach to the issues of geriatrics. Besides, we must also distill the most important advances in the science of aging and incorporate the evidence of scholars in gerontology, anthropology, humanities, psychology, public health, sociology, social work, biology, medicine, and other, similarly related disciplines. It is time that our attention centers on areas pertinent to the well-being of the adult population such as work and retirement, social networks, context and neighborhood, discrimination, health disparities, long-term care, physical functioning, care giving, housing, and end-of-life care. Bringing our knowledge of this understudied group in line with their needs and the impact they will have on society will be an “achievable” challenge of current and future generations of scholars. This publication has been prepared underlying this motto to designate this issue as geriatric special. We hope that the readers will appreciate the articles of this issue.
(Santa Misra) Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 INTRODUCTION TO A NEW SCIENTIFIC DISCIPLINE: MANAGEMENT OF ALLSELVE'S ENLIGHTENMENT AND EMPOWERMENT(MOSEE) AND CREATION MANAGEMENT BASED ON KOREAN CULTURAL TECHNOLOGY, HONG-IK PROSPERITY AND PEACE(METHODOLOGIES OF 366 VIRTUES OF HUMAN BEING) Jaeyoon Rhee* ABSTRACT Corporations in modern capitalishe society define the human beings as a means of producing performances, while utilizing them as resources and tools in the process of management in order to maximize profits from the stockholders' and top-level management's viewpoint for the sake of efficiency and effectiveness of the management only. In the situation, humanity is overlooked and the extreme diversions in the income structures are deepened, while one percent of people govern the rest 99% of people. Hence, people suffer from relative poverties, while feeling unhappy, even though they have been much better in materially-abundant and convenient living environment. The theories based on modern knowledge management and practices have the clear limitations, if not impossible, in solving the critical issue of humanity deprivation in the modern society. I would like now to create and show clearly an alternative academic field and ways and means to recover the genuine humanity and thus to solve problems people encounter in routine lives. The new academic field and concepts, I would like to introduce the Management of All Selve's Enlightenment and Empowerment (here after MOSEE). Keywords : AllSelves, Enlightenment, Empowerment, Humanity Concepts of a New Academic Area: The Management of All Selve's Enlightenment and Empowerment The concept of the Management of All Selve's Enlightenment and Empowerment (MOSEE) refers to enlightenment and empowerment of human spirits or consciousness. That is, it transforms people who are the major entities of corporation management, while the transformation change people to have the really built-in freedoms, and therefore inspired human relationships in joyful ways with family members, other people, jobs, money, capitalism systems involved. While individuals are transformed, the MOSEE also transforms the organizations and communities, such as families, corporations, societal organizations, one's own and other countries, world societies, globe natures and the universe. The MOSEE has developing powerfully workable ways and means that are applicable to people and organizations, by which everybody and every organization enlighten and empower with each other and transform all collectively. MOSEE is an consolidated and integrated concept of Korean traditional philosophies and oriental enlightenment by utilizing western management science analytical methodologies.
*Professor Emeritus, Chung-Ang University, Seoul, Korea. [email protected], Chief of Grand Education and Research of World Senior Complex Study Group 4 Rhee / Introduction to A New Scientific Discipline Definition of Enlightenment The enlightenment in MOSEE means that people realize that human beings are the origin being so that the being is a part of the whole and all, and at the same time, the whole and all selves are not separated from the whole at all. We can understand easily the hologram concept. People create their own Being and are able to manage the reality with concentration of the Table 1: Comparison of Law for Management for Possession and Law for Figure 1: Diminishing Law of Performance VS Management for Being Enlarging Law of Performance Diminishing law due Enlarging law due to to Management for Management for Life Possession path to enlightenment Being Surviving life. Life for enlightenment Management for Management for Being possession CHRONOS(Man-made KAIROS(Universe time) time) No Being(Identity) Real Being reality Unreality Religion: God for myself Religion: God for All only people Survival Adaptation Open minded Give in most living no freedom valuable things Restoring process for integrity Authenticity Reactive Self Reaction Sour ce of influence to get to circumstances job done Creating new Ego(various conditions Being make new required) environment and circumstances Real Being Freedom Reactive Human is Bio management of the Being in the freedom and the Space Create new Robot equipped with boundless realm of value involved. Otherwise, people tend to just do basic software possibilities lots without their own Being attached to the I am separate unit on my I am a part of whole and all own and whole and all itself survival business games in order to take the Continuous changes Create something new from ownership and gain the profits included, which I something from nothing that is everything something call the management for Possession, not the Past Pr esent Future Past Present ? Future management for concentration of Being.
Comparison of Two Laws Diminishing law of resources due to the management for Possession based on attachment to the survival business games, and enlarging law of resources due to the management for concentration of own Being. Management for possession may lose the future of people, since past experiences affect present's decision-making which controls future. Only if commitment to future creates being for present, future comes here around present. Comparison of two curves Diminishing curve of performance due to the management for Possession and enlarging curve of performance due to the management for Concentration of Being.
5 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
What does it mean to live? I live for what? These questions are indeed the universe still exploring the human race since local proposition and questions which are common to every tribe and religion. The reason is anyone else in common and behavior is the Living. namely the gathering of the ( ) movement alive, so themselves and reacting to moving the movement of the gathering that they are dead, and vice versaWon't move since I don't have and not responded.People living carelessly, not moving, moving move order to achieve a purpose. You want him to form a necessary work to do something.A certain that doing so is caused by external, which, for action on anything to become known, and by the reaction from the outside experienceWe simply. So a matter that comes in and learning needed to achieve some- thing the place simultaneously in the process of doing.Haengchon this mudstone has shown as " , and ( ) was to know only, and ( ) to have to do. ( )" < >. Giving birth is achieving. As explained to the registration of every three people and ( ) all things flying when you show up to the world means .
Therefore, some people to do something to accomplish and learn from all things born of the world, including the fundamental character can be called. Learning still trying to live act of life and people originally haengchon such that mudstone represented by the following statement." "
6 Rhee / Introduction to A New Scientific Discipline Conclusion Individuals and corporations may create highly qualified human consciousness through the aid of MOSEE, which may produce a new world or relationships among people. Knowledge management and informative education, along with lands, capitals, human resources, and technology and development skills, as the determinants for the management performance, define outer generated capacity in the four dimensions. MOSEE adds human conciseness in the five dimensions as inside generated capacity, which results in integrated capacity which combines outside and inside generated capacity. The integrated capacity renders integrity and completeness of authentic creation. References Jaeyoon Rhee. (2012). "Management of All Selves Enlightenment and Empowerment (MOSEE)". Pulipmunhwasa, l, Korea.2012. Jaeyoon Rhee. (2012). "Management Of AllSelves' Enlightenment and Empowerment (MOSEE)". Practical Meditation Leader. Pulipmunwhasa, Korea. 2012. Jaeyoon Rhee. (2007). "The spirit philosophy of Ha-Gon Rhee and its meaning in modern management". Journal of Inaugural Symposium of the Academic Society For the Dam-Hun Ha-Gon Rhee and Bak- Un Dae-Yun Shim Benefit and Information Management Creation and Ethics, Pulipmun,Vol1 pp1- 12. Jaeyoon Rhee, (2012). "Discussion on overcoming contradictions in business through Dae-Yoon Shim's Benefit and Ho-Gon Rhee's Spirit Philosophy, Journal of Dae-Yoon Shim's Research, Pulipmun, Vol.1,pp26-35. The second quantum revolution, New Scientist, 20. June (2007).
7 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 GERONTOLOGY: COMMUNICATION DISORDER Jaya Sankar Panda* Abstract Human beings depend on communication in every stage of their day-to-day activities that include social and leisure activities, community involvement, personal relationships, and meeting needs for daily living. Interpersonal communication is a critical tool for life adjustment, linking people to their environment. Many of these functions change with typical aging. In presence of communication disorders these links tend to get easily broken. Communication disorders vary in terms of type, severity, and co-occurrence with other symptoms that limit mobility, vision, endurance and cognition. Even though communication disorders affect people of all ages, the dominance and complexity of these conditions increase with age. Disabilities associated with communication disorders are dynamic processes that vary with time. This article presents various communication disabilities associated with aging and how these disabilities affect important functions. Suggestions are also provided so as to preserve and enhance communication function in old-aged adults. Keywords : Gerontology, Speecherrar, Aphasia, Dementia. Introduction : Aging Effect With aging, communication skills change subtly at least in part because of changes in various biological parameters such as physical health, depression, and cognitive decline. Aging is mostly responsible for physiologic changes in hearing, voice, and speech processes. A person’s age can be predicted with fair accuracy by speech characteristics which include voice tremor, pitch, speaking rate, loudness, and fluency. Communication skills tend to decline other than some language skills that normally remain intact. Highly over-learned language structures and processes (e.g., those used in greetings and social discourse) appear relatively unaffected by age; and, passive vocabulary (e.g., word recognition) and other basic lexical and semantic skills (e.g., retention of underlying semantic meanings) remain generally unimpaired and often improve through adulthood up to the early seventies. So, vocabulary, grammatical judgment, and repetition ability are relatively stable with age; on the other hand, comprehension of complex utterances and naming tends to decline. Although changes in communication skills such as voice may be subtle and gradual, they have clear life consequences, since communication is not just about transactions such as exchanging information and transferring messages; rather it also serves an important role in establishing and maintaining social connection. Communication Pattern Phonological and morphological elements as well as rule systems are not disrupted in normal ageing. And, basic pragmatic skills are well retained into old age including signaling and repairing misunderstandings. The spoken and written narratives of older adults are well-preserved and are valued significantly in the domain of social communication. Their stories contain elaborate narrative structures including hierarchically elaborated episodes. In general, such stories begin
*Audiologist and speech language pathologist, SVNIRTAR, Olatpur, : Bairoi, Cuttack-10, Odisha, E mail : [email protected] 8 Panda / Gerontology: Communication Disorder with description of initiating events and motivating states, details of protagonists’ goals and actions, and ends with summarizing outcomes of protagonists’ efforts. Apparently, older adults know how to capture and to maintain the attention of their partners to make their narratives more appealing. It is well-known that older adults use shorter sentences with fewer clauses (and, multiple clauses) as a function of age-related decline in language. They also use more revisions and interjections in comparison to younger adults. Most studies on the syntactic complexity used by older adults show reduced complexity with advancing age across a wide range of experimental tasks (e.g., sentence imitation, written and oral discourse production, text comprehension and imitation and life span diary studies). Older adults who are less educated and who are much older (above 80 years) experience increasing difficulty with word retrieval and recall. Performance of older adults on semantic verbal fluency tasks declines with age; and is influenced abundantly by low levels of formal education. Word class (nouns and verbs) and word frequency together with personal relevance influence abilities of older adults to recall and to retrieve words. In fact, nouns and verbs that occur less frequently in their vocabulary (i.e., limited semantic meaning network) and which are less personally relevant are more difficult for them to say or to write, particularly under multitask environment. Older adults often experience “tip of the tongue” (TOT) phenomenon, generally for names of people. However, sound cues are sometimes helpful towards word retrieval more than semantic word cues. In general, language use and language-related activities also, sometimes, influence naming abilities. This indicates that those older adults who use language frequently as an integral part of their lives (e.g., crosswords, public speaking) and who value it highly are prone to have fewer naming problems. In view of overall slowing of cognitive processes reflected in longer response times and increased length of pauses, older adults take longer to say or to write words during naming tasks, sometimes producing errors across word classes. Older adults often show circumlocution while experiencing word finding problems. Notwithstanding occurring age-associated hearing problems in parallel, older adults experience difficulty understanding spoken and written sentences in which a relative clause occurs at the beginning of the utterance or sentence. Reduced auditory comprehension is worsened by declines in age-related verbal working memory especially on more than one task. Worrall and Hickson (2003) noted that declines in the comprehension of spoken or written discourse among older adults become evident when tasks place stress simultaneously on cognitive and linguistic systems by increasing cognitive demands or removing/reducing linguistic information. Schneider, Daneman and Pichora-Fuller (2002) showed that older adults (regardless of hearing ability) have more trouble understanding speech in everyday communicative contexts. They found that older adults do not remember in detail as younger adults and that older adults experience more difficulty answering integrative questions. With these findings, it is summarized that cognitive processes (generalized slowing, declines in verbal working memory deficits in inhibitory processes, and attention) and/or sensory and perceptual processes (auditory declines in older adults) give emphasis to discourse comprehension problems. Firstly, older adults, particularly those under that age of 75 to 80 years, have a huge collection of linguistic resources to offset age-associated hearing loss. Aural rehabilitation options
9 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 should consist of supportive elements (of relatively preserved context processing, elaborative story-telling and intact pragmatic skills). Secondly, instructions for auditory assessments must not include complex syntactic structures. It would be better to avoid placing background information or relative clauses at the beginning of sentences. Thirdly, provision of additional responses times should be ensured, and it would be better to be vigilant for related word errors on word discrimination and word repetition tasks. Older adults are inclined to slow response times and to produce words related in meaning to the target word during word repetition tasks. In general, clinical audiologists can take advantage of the retained language and communication abilities for case history taking, during word and sentence discrimination tasks, and for aiming at linguistic and practical supports in aural rehabilitation programs. Health Factors Aphasia Aphasia is a syndrome (i.e., collection of behavioral and neurological features) of language problems that result from focal damage, usually of rapid onset, to cortical and/or sub-cortical regions involved in the language dominant cerebral hemisphere. All modalities of language are impaired to varying degrees in those with aphasia including spoken language, writing, reading, auditory comprehension and the use and understanding of nonverbal language (e.g., gestures, facial expressions, etc.). Clinical audiologists must be aware of age-related hearing loss is very much common for older adults who have aphasia. Hence, added vigilance during testing should be ensured for those individuals with aphasia, who have significant listening comprehension problems, in order to understand the instructions. Motor Speech Disorders Motor speech disorders include the conditions of dysarthria and apraxia. Dysarthria refers to speech movement disorders caused by damage to the central and/or peripheral nervous systems. It often occurs in older adults as a result of acquired progressive and degenerative neurological conditions such as Parkinson’s disease or amyotrophic lateral sclerosis (ALS). Speech movements in those with dysarthria are weakened in the speed, the force, the range, the direction, or the timing of movements. There can also be spontaneous movements or alterations in muscle tone. Apraxia refers to a neurogenic disorder in which there are impairments in one’s (i) abilities to select, (ii) to program and (iii) to coordinate muscle movements for specific preferred tasks. The disruptions in coordinated muscle movements are unrelated to auditory comprehension problems, to cognitive impairments, to disruptions in reflexes, or to impaired muscle strength or tone. Out of several types, apraxia relevance with the speech-language impairment is referred as oral or buccofacial apraxia. Amyotrophic Lateral Sclerosis (ALS) Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder linked to cell death of lower motor neurons of the brainstem and spinal cord, and of upper motor neurons of the cerebral cortex. It is the third most common adult-onset neurodegenerative disease. 10 Panda / Gerontology: Communication Disorder In fact, speech problems are a prominent feature of individuals with ALS. The mixed spastic-flaccid dysarthria associated with ALS resulting from involvement of multiple motor systems includes the predominant speech features of imprecise consonants, hypernasality, harsh voice quality, slow speaking rate, monopitch and short phrases. The progression of their mixed dysarthria leading to anarthria (complete speechlessness) contributes to their overall communication problems. Clinical audiologists need to educate and to train caregivers during aural rehabilitation programming to reduce complexity of their messages in addition to supportive memory and attention stimulation strategies (e.g. as using writing, reducing sensory distractions and optimizing sustained attention techniques). Mild Cognitive Impairment (MCI) Mild cognitive impairment (MCI) is considered a transitional state between normal, age- related cognitive problems and dementia. This has been developed from earlier concepts of cognitive decline in aging without dementia including age-associated memory impairment, age- associated cognitive decline, cognitively impaired not demented or cognitively impaired not demented yet, among other terms. CI is defined operationally by Pedersen, Smith, Warring, Ivnik, Tangalos & Kokmen (1999) using the following criteria: Complaint, preferably corroborated by informant Objective memory impairment corrected for age and education Largely intact general cognitive function Essentially preserved activities of daily living (ADL) Not demented No specific medical, neurological or psychiatric causes for memory difficulty For clinical audiologists, the best approach is to write down assessment instructions when they suspect a client for MCI. It would be better to provide them those with proper indication, prior to and during the assessment. In addition, aural rehabilitation programming must include written documentation for clients and their family or professional caregivers to review. A thorough review of aural rehabilitation strategies must be undertaken simultaneously with clients with MCI, their family members or with other professional caregivers to ensure that the approaches and techniques are well understood, remembered and invoked. Moreover, clinical audiologists must refer clients suspected of having MCI to their attending physician(s), if this has not already been undertaken, for detailed follow-up on the suspected cognitive impairment. Dementia Dementia is an acquired progressive degenerative syndrome that affects multiple cognitive systems and processes. Individuals with dementia exhibit deficits of gradual onset and continual decline including the core feature of memory impairments and one or more of the followings: Language problems Movement programming problems (apraxia)
11 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Perceptions stripped of meaning (agnosia) Disturbance in executive functioning Individuals in the early/mild clinical stage usually are aware of their language and communication difficulties. The most prominent problem is word finding difficulties for names of people, places, objects and actions. They often use stereotyped phrases as a result of their deteriorating semantic memory system and processes but generally, their expressive language is sufficient for most social situations. Individuals in the middle/moderate clinical stage generally are less aware of their language and communication problems. They exhibit pronounced word finding problems including circumlocution, and semantically empty and irrelevant utterances. They frequently repeat words, utterances, and ideas as a result of deteriorating working memory and meta-linguistic skills. Some may make inappropriate personal comments, generally being insensitive to contexts and partner factors in what to and what not to say or write. From discourse perspectives, those in the middle clinical stage digress and ramble yielding poor topic maintenance. By the late stage, individuals possess a restricted range of language skills but do retain fundamental elements of communication such as turn-taking, eye-contact and responsiveness to spoken questions and commands. They now begin to demonstrate a breakdown in the fundamental aspects of grammar and syntax and show disruptions in their speech without proper articulations. Their auditory comprehension is best preserved for frequently occurring and personally relevant words. They will respond to and understand not so much the semantic content of what is said but rather to the prosodic features including rate of speech, its pitch contours and to pause, loudness and personal-familiarity cues. Firstly, audiologist must recognize that individuals with dementia can learn to use assistive listening devices successfully. There is emerging evidence that individuals with dementia can learn and retain new information via specific interventions such as spaced retrieval. Fitting for devices must include a comprehensive gathering of relevant communication contexts and partners in which the device will be used and who of the potentially multiple caregivers (e.g., family, neighbors, formal professional) can provide support in the use of and in troubleshooting any problems with the device. Secondly, audiologists will need to adjust the manner in which assessment instructions are provided to clients and the way in which assessment protocols are completed. Family caregivers can be briefed a priori of the assessment tasks and sit in with their relative during the testing, helping to remind their relative of the required responses. Finally, clinical audiologists need to consider mechanistically simple assistive devices for use (e.g., no remote adjustments but pre-set settings) and what electronic feature can be used to help the person with dementia or her/his caregiver to locate the device should it be misplaced. Communication Enhancement Firstly, it should be ensured that older adults are known by and possess unique characteristics or name(s). By using respectful forms of address (e.g., Mrs., Mr., Dr., etc. vs. first or nick-
12 Panda / Gerontology: Communication Disorder names) and explicitly acknowledging their accomplishment or social status, it will go a long way to reinforce their self profile. Secondly, it would be better to consult and negotiate with older adults. Consult with them about preferences, choices, and needs. Older adults become informed decision makers by offering a range of choices for assistive listening devices along with listing the strengths and weakness of each option. Thirdly, validation of older adults’ reality must be provided. It would be better to acknowledge their feelings, connectedness and person within the context of their hearing problems. In this process, one has to show empathy toward the physical, social and emotional difficulties that they may be experiencing as a result of their hearing impairment. Fourthly, collaboration with older adults must be encouraged, by aligning your goals with theirs. Togetherness in task completion must be adopted by working as a unified unit to achieve hearing related goals. This will lead to adopt their perspective as decisions are made concerning hearing device options. Finally, one has to be a catalyst for older adults to accomplish what they would otherwise be unable to do without other’s help. References Appell, J., Kertesz, A., & Fisman, M. (1982). A study of language functioning in Alzheimer patients. Brain & Language, 17, 73–91. Baressi, B. A., Obler, L. K., Au, R., & Albert, M. L. (1999). Language related factors influencing naming in adulthood. In Hamilton, H. E (Eds), Language and communication in old age: multidisplinary perspective (pp. 76–89). NY: Taylor & Francis, Inc. Baum, S.R. (1993). Processing of centre-embedded and right-branching relative clause sentences by normal elderly individuals. Applied Psycholinguistics, 14, 75–88. Bayles, K. A., Boone, D. R., Kaszniak, A. W., & Stern, L. Z. (1982). Language impairment in dementia. Arizona Medicine, 39 (5), 308–311. Bayles, K.A. & Tomoeda, C.K. (2007). Cognitive-communication disorders of dementia. San Diego, CA: Plural Publishing, Inc. Bayles, K.A., Tomoeda, C.K., Cruz, R.F., & Mahendra, N. (2000). Communication abilities of individuals with late stage Alzheimer’s disease. Alzheimer’s Disease and Associated Disorders, 14, 176–181. Brockington, A., Ince, P., & Shaw, P.J. (2006). The clinical and pathological spectrum of ALS. In M. J. Strong (Ed.), Dementia and motor neuron disease (pp. 31–57). United Kingdom: Informa UK Ltd. Burke, D.M., MacKay, D.G., Worthley, J., & Wade, E. (1991). On the tip of the tongue: What causes word finding failures in young and older adults? Journal of Memory and Language, 30, 542–579. Caramazza, A., & Hillis, A.E. (1991). Lexical organization if nouns and verbs in the brain. Nature, 349, 788– 790. Cooper, P.V. (1990). Discourse production and normal aging: Performance on oral picture description tasks. Journal of Gerontology, 45, 210–214.
13 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Crook, T., Bartus, R.T., Ferris, S.H., Whitehouse, P., Cohen, G.D., & Gershon, S. (1986). Age-associated memory impairment: Proposed diagnostic criteria and measures of clinical change – report of a National Institute of Mental Health Work Group. Developmental Neuropsychology, 2, 261–276. Crossley, M., D’Arcy, C., & Rawson, N. S. (1997). Letter and category fluency in community-dwelling Canadian seniors: A comparison of normal participants to those with dementia of the Alzheimer or vascular type. Journal of Clinical Experimental Neuropsychology. 19 (1):52–62. Darley, F. L., Aronson, A. E., & Brown, J. R. (1975). Motor speech disorders. West Washington square, Philadelphia: W.B. Saunders Company. Dickey, L., Kagan, A., Lindsay, P., Fang, F., Rowland, A., & Black, S. (2010). Incidence and profile of inpatient stroke-based aphasia in Ontario, Canada. Archives of Physical Medicine and Rehabilitation, 9,1, 196–202. Duffy, J.R. (2005). Motor speech disorders: Substrates, differential diagnosis, and management 2ed. St. Louis, MO: Elsevier Mosby. Garcia, L. J., & Joanette, Y. (1997). Analysis of conversational topic shifts: A multiple case study. Brain and Language, 58, 92–114. Hancock, A. B., LaPointe, L. L., Stierwalt, J. A. G.,Bourgeois, M. S., & Zwaan, R. A. (2007). Computerized Measures Of Verbal Working Memory: Performance In Healthy Elderly Participants. Contemporary issues in communication science and disorders, 34, 73–85. Hopper, T., Mahendra, N., Kim, E., Azuma, T., Bayles, K.A., Cleary, S. et al. (2005). Evidence-based practice recommendations for individuals working with dementia: Spaced retrieval training. Journal Medical Speech-Language Pathology, 13 (4), xxvii–xxxiv. Heller, R.B. & Dobbs, A.R. (1993). Age differences in word finding in discourse and nondiscourse situations. Psychology and Aging, 8 (3), 443–450. Kemper, S. (1986). Imitation of complex syntactic constructions by elderly adults. Applies Psycholinguistics, 7, 277–287. Kemper, S. (1992). Language and aging. In F.I.M. Craik and T.A. Salthouse (Eds.). The handbook of aging and cognition pp. 213–270/ Hillsdale, NJ: Lawrence Erlbaum Associates. Kemper, S., Rash, S.R., Kynette, D. & Norman, S. (1990). Telling stories: The structure of adults’ narratives. European Journal of Cognitive Psychology, 2, 205–228. Kemper, S., Schmalzried, R., Herman, R., Leedhal, S., & Mohankumar, D (2007). The effects of aging and dual task demands on language production. Aging, Neuropsychology, and Cognition, 16, 241– 259. Kempler, D. (1991). Language changes in dementia of the Alzheimer type. In R. Lubinski, (ed.) Dementia and communication, (pp. 98–115). Philadelphia: Mosby. Kent, P.S. & Luzscz, M.A. (2002). A review of the Boston Naming Test and multiple-occasion normative data for older adults on 15-item versions. The Clinical Neuropsychologist, 16 (4), 555–574. Levy, R. (1994). Aging-associated cognitive decline. International Psychogeriatrics, 6, 63–68. Maxim, J., & Bryant, K.L. (1994). Language of the elderly: A clinical perspective. London: Whurr Publishers.
14 Panda / Gerontology: Communication Disorder McNeil, M.R. (1982). The nature of aphasia in adults. In N.J. Lass, L.V. McReynolds, J.L. Northern, & D.E. Yoder (Eds): Speech, Language, and Hearing: Vol II, Speech and Language Pathology. (pp. 692– 740) Philadelphia, WB Saunders. Mendez, F. M., & Cummings, J.L. (2003). Dementia: A clinical approach. Philadelphia, PA: Butterworth- Heinemann. Obler, L.K., Au, R., & Albert, M.L. (1995). Language and aging. In R.A. Huntley & K.S. Helfer (Eds.), Communication in later life (pp. 85–97). Boston, MA: Butterworth- Heinemann. Orange, J.B (2009). Language and Communication Disorders in Older Adults: Selected Considerations for Clinical Audiology Hearomg Care for Adults 2009, 87-102. Pedersen, R.C. (2003). Conceptual overview. In R.C. Pedersen (ed.), Mild cognitive impairment (pp. 1– 14). NY: Oxford University Press. Pedersen, R.C., Smith, G.E., Warring, S.G., Ivnik, R.J., Tangalos, E.G., & Kokmen, E. (1999). Mild cognitive impairment: Clinical characterization and outcome. Archives of Neurology, 56, 303–308. Pratt, M.W. & Robbins, S.L. (1991). That’s the way it was: Age differences in the structure and quality of adults’ personal narratives. Discourse Processes, 14, 73–85. Schneider, B.A. Daneman, M., Pichora-Fuller, MK. (2002). Listening in aging adults: From discourse comprehension to psychoacoustics. Canadian Journal of Experimental Psychology, 56, 139–52. Shadden, B.B. (1997). Language and communication changes with aging. In B.B. Shadden and M.A. Toner (Eds.). Aging and communication: for clinicians by clinicians, 135–170. Austin, TX: PRO- Ed. Square, P.A. (1989). Acquired apraxia of speech in aphasic adults. Philadelphia, PA: Taylor & Francis. Worrall, L. E., & Hickson, L.M. (2003). Communication disability in aging: From prevention to intervention. Clifton Park, NY: Thomson Delmar Learning.
15 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 STATE OF LIVELIHOOD CAPITALS IN RURAL INDIA: A CONCERN TOWARDS ITS DEVELOPMENT Sasmita Ojha* Bishnuprasad Mohapatra** Abstract Since independence of India both the central and state government are focusing on the rural development through the variousplans, programmes and policies. These programmes are carried out for theoverall development in rural community through the process of improving quality of life and economic wellbeing of rural people. The quality of life, economic wellbeing and basic necessities are the significant elements of livelihood structure of individuals. The livelihood sustenance is the foremost theme of brining rural development in India and it consists of five major capitals that is; Human, Social, Physical, Financial and Natural. The present paper highlights the state of livelihood capitals in rural India. Human capital with reference to educational attainment and poverty level; Financial capital with reference to availability of banking services, income sources, debt and saving; Physical capital with reference to accessibility to basic services and infrastructure that is; road, housing; Natural capital with reference to land holding and forest dependency; and Social capital as Self Help Groups (SHGs) and migration. Keywords : Livelihood, Capital, Assets, Rural Development, India Introduction In the twenty first century, the word rural development has become anemerging debate and buzz- word for the researchers, academies, civil society as well as the government. The overall development of a country is based on its people and most of the people live in the rural areas. According to the father of nation M.K. Gandhi if the village will prosper India will prosper and if the village will perish India too will perish.So, the improvement in quality of life, livelihood security, wellbeing and economic development of these sections of people will definitely bring country’ssocio-economic development. Generally, rural development connotes overall development of the rural areas and of the people living in these areas by improving the quality of life and economic wellbeing. It includes development of agricultural and allied sector, increasing productivity, economic growth, development of community services for basic needs, development of village and cottage industries, infrastructure development, skill development and to involve rural people in the whole development activities and process to ensure social justice (Singh, 2009 and Sharma, 2015). In the words of Robert Chambers rural development refers to“A Strategy to enable a specific group of people, poor rural women and men to gain for themselves and their children more of what they want and need. It involves helping the poorest among those who seek a livelihood
*Research Scholar at Nabakrushna Choudhury Centre for Development Studies (NCDS), Bhubaneswar-751013, Po-RRL, Odisha Ph.No. 9437314739, 9778861106, Email Id: [email protected] **Research Scholar at Nabakrushna Choudhury Centre for Development Studies (NCDS), Bhubaneswar -751013, Po-RRL, Odisha Ph. No. 9437314739, 9778861106, Email Id: [email protected], 16 Ojha & Mohapatra / State of Livelihood Capitals in Rural India in rural area to demand and control more of the benefit of development. The group includes small scale farmers, tenants and the landless” (1983:147). The basic elements of rural development encompasses fulfillment of basic necessities of life, self - respect and freedom of the rural people. Whereas Livelihood refers to how people make their living and fulfill basic necessity for a good life like food, shelter, clothing etc. in day to day life through the capability, activities and assets. A livelihood is sustainable which can cope with and recover from stress and shocks, maintains and enhances its capability and assets and provide sustainable livelihood opportunity for the next generation and which contributes net benefit to other livelihoods at local and global levels and in the short and long term (Chambers and Conway, 1992) and the livelihood of individual or society is largely determined by the capitals or assets pentagon. So the overall development and poverty alleviation of rural society is largely based on the sustainability of livelihood activities through the access to capitals among the individuals in rural society. Objective and Methods Followed The present paper makes an attempt to understand the present situation of rural livelihood in general and livelihood capitals i.e. Human, Physical, Financial, Natural and Social, in rural India particularly. To understand the state of rural livelihood in India, the paper focused on secondary sources information like census 2011, Indian Rural Development Report 2013-14, NSSO data etc. Rural People and their Livelihood in India In India according to 2011 census 833 million people live in rural areas and in about 6 lakh villages (IDFC, 2015), which is around 68.64 percentage of the total population. Though the number is decreasing day by day due to urbanization and industrialization but it has its own importance in the Indian society. Both rural community and urban society differ from each other on the basis of their own physical and socio-cultural environment, way of life, norms and values, economic activities etc. The livelihood statuses of rural people are largely based on their capability, exposures to risk in the activity, expenditure and their strategy towards livelihood sustenance. The livelihood activities of rural people in India are largely based on the agricultural and its allied activities, wage employmentwith very low income. But ironically now days due to demographical shift in rural India non-farm employment is increasing at a high rate. Most of the people are living in thebelow poverty line strata and the situation of tribal and scheduled caste people is found precariousin rural areas and due to their low human capital condition they are further marginalized and excluded from the mainstream society. India, since its independence launched different programmes and projects for the poverty alleviation and overall development of rural people. These programmes and projects are largely based on the employment generation, infrastructure and communication development, sanitation and health improvement, skill enhancement etc. for better livelihood outcome through enhancement of livelihood capitals in the rural areas. However, the effectiveness of these programmes, policy and projects is a question mark for the rural development. Livelihood Capitals in Rural Areas Livelihood capitals are foremost and vitalfor the development of rural society. It provides ‘energy’ for the upliftment of livelihood outcome among households. Ellis (2000) in his study
17 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 pointed out that natural, social, human, financial and physical capitals, activities and access to these together three determined the individual or household livelihood. Department for International Development (DFID) in their Sustainable Livelihood Framework guidance note suggests five major capitals to livelihood analysis and they are presented as assets pentagon. Chambers and Conway divide capitals or assets structure into two types: one is tangible assets and another is intangible assets. Tangible assets include resources and stores i.e. saving, credit, gold, jewellery, land, water, forest, tools, domestic assets, occupational assets, livestock etc and intangible assets include claims and access i.e. demand and appeals for rights, issues etc. So, both the individual or household livelihood is based on the maximum utilization of both the tangible and intangible capitals in their activities to satisfy their needs.The development of capitals in villages, communities, groups, households, and individuals, is not only responsibility of individual but also other stake holders like government and non-government organizations. As livelihood framework has been designed to address the issues faced by the rural and underdeveloped people. So, both government, voluntary, non-government organizations and donor agencies has been continuously introducing different plans, policies and programs for the rural people in general and particularly for the disadvantaged people like the tribals, Dalit, women etc. to make their livelihood sustainable. These stakeholders are engaging themselves in infrastructural, educational, occupational, social, health, entrepreneurial services for development of poor rural people through the overall development in rural areas. Each assets or capital structure has its own importance in bringing livelihood outcome. Human Capital In the livelihood analysis for rural people, human capital poses a major factor in analyzing livelihood enhancement of individuals and households. It ischaracterized by individual knowledge, ability, capability, skills and health as the main mechanism which help in transforming the intangible capitals of individuals and households to labour and income for final livelihood outcome. At household level it varies according to household size, leadership potential, skill levels, health status etc. within the members of household. Generally it implies the amount and quality of individual poses in the household for poverty alleviation. The poverty is directly linked to the level of education and attainment of skill among the individuals. It is found that 216.5 million (25. 7 %) rural peoples in India are under the belowpoverty line (IDFC, 2015) where as one third of the rural population are under the category of illiteracy (census 2011). Thus it is clear from the data that both attainment of education and poverty level have a strong and close nexus in between them. So the attainment of higher levelof education will definitely minimize the poverty level among the peoples. Due to poverty, rural people generally fail to take adequate nutrition, calories and vitamins to keep them and their family healthy from different diseases and illness. As a result it directly affects earning capability of the individual and the household because of various seasonal and endemic diseases over the year (Meher, 2007). For the human capital development,government of India adopted different plans and programmes for them i.e. Pradhan Mantri Kaushal Vikas Yojana, Saksham or Rajiv Gandhi Scheme for Empowerment of Adolescent Boys, Sabla or Rajiv Gandhi Scheme for Empowerment of Adolescent Girls, Kasturba Gandhi Balika Vidyalaya, Mid Day Meal Scheem,
18 Ojha & Mohapatra / State of Livelihood Capitals in Rural India National Literacy Mission Programme, Deen Dayal Upadhyaya Grameen Kaushalya Yojna and so on for the capacity and capability development of individuals to attain their livelihood and will help in bringing the overall rural development. So, to the attainment of rural development through human capital among individual and households in rural and less developed areas can be developed through the attainment of education and skill,employment as well as individual’s health status etc. Financial Capital Financial capitals occupy anessential position in bringing rural development and sustainable livelihood. Financial capitals can be easily converted through the exchange with other capitals. It refers to available stocks and regular flow of financial resources that helps individual and householdsto achieve their livelihood outcome. In analysis of financial capital stock includes cash, liquid assets, bank deposit, jewellery etc. where as regular flow of financial resources refers to labour income, pension etc. which help to achieve livelihood objectives. It also includes individual assets, household assets, occupational assets, livestock assets, individual and household loan, shares etc. which households possess and can be converted into other capital or assets (Akki and Reddy, 2015 ; Ellis, 2000). According to census 2011, in rural areas only 54.4 percent households were availing banking services in India. Further the 70th round National Sample Survey Organization (NSSO- 2013) data over All India Debt and Investment Survey (AIDIS) reveals that in rural areas 68.8 percent households had a bank account. The saving in rural areas is considered as the key factor in mitigation of risk and capital building. It constitutes the smaller part of individual or household total assetsin rural areas of India (1.65 %). In rural areas agriculture contributes 62 per cent of total income followed by non agricultural self employment (20 percent). The structure of saving in rural areas is largely based on the income of individual or household. But unfortunately,due to low incomeandhigh povertyin rural areas, hardly do they think about saving. Further AIDIS reveals that 1.72 percent rural household assets found in financial form. The incidence of debt among rural household is 31.4 percent, among them 45.9 percent are found among the rural cultivators. In spite of bank, postal and cooperative societies in rural areas non- institutional financial players were actively playing a major role (Srinivasan, 2016). For the improvement in the state of financial capital government of India implemented different programmes and policies for saving, income generationand insurance for the rural people. Some of the programmes are Atal Pension Yojana, Integrated Rural Development Program, Mahatma Gandhi National Rural Employment Guarantee Act, Pradhan Mantri Suraksha Bima Yojana, Pradhan Mantri Jeevan Jyoti Bima Yojana, Pradhan Mantri Jan Dhan Yojana, Rashtriya Swasthya Bima Yojana, Sampoorna Grameen Rozgar Yojana etc. These programmes are carried out in rural areas for improvement of income and saving to mitigate the risk attached to individual or household daily life and to maintain a sustainable livelihood. Physical Capital Among the livelihood capitals, physical capital is the base on which the process of livelihood activity and outcome of the individual is achieved. It refers to manmade produced goods
19 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 comprises of basic infrastructures, machines, equipment and produce goods like health centers, schools, road, shelter, building, transport, water supply, sanitation, energy and communication etc. which helps in transforming livelihood activities through improving living condition, productivity and by reducing rural poverty. The accessibility to basic services in rural India; like drinking water, sanitation, and electricity are found inadequate and unequal in nature, only 24 percentage rural household had these basic facility as of 2011-2012. Since the launching of Pradhan Mantri Gram Sadak Yojana (PMGSY) about 4.12 lakh km roads are constructed in 1.02 lakh habitation as per 31Auguste 2014 and as per 2012, 80 percent of rural households are using electricity under Rajiv Gandhi Grameen Vidyutikaran Yojana (RGGVY).NSSO 69th round data reveals that tube well/ hand pump (52.4 %) is the major source of drinking water followed by the tap water (31.2 %) and 46 percent of households are using the source of water within their premises and 50 percent near their premises. Further about the sanitation facility in rural areas, it is found that 60 percent households do not have latrine facility in the year of 2011-12. Shelter remains a major componentin physical capital analysis. Till 2012 in rural India it is found that 66 percent are ‘pakka’ houses and 29 million houses are built in rural areas during 1985-2012 under Indira Awaas Yojana. Health care infrastructures are found very inadequate and poor quality in rural areas as well as health care providers also found shortfall.At the same time quantitative educational infrastructure progress has been found without quality improvement (IDFC, 2015). However, the infrastructure plays a major role in eradicating poverty and generating livelihood outcome of individual. It will definitely help in leading the basic necessity of life of rural peoples. Natural Capital In interrogating livelihood security among rural people and less developed backward areas, natural capital plays a significant role in strengthening livelihood structure among the region and people. In sustainable livelihood structure natural capital refers to natural resources like land, water, forest, air etc. These are the indispensablemechanism of daily life and survival among rural households. Measurement of natural capital assets among the rural households is largely based on their land holding capacity, availability of forest products and resources, availability of water resources etc. Land is considered as the sustainable productive capital in generating and accelerating the livelihood outcome among the rural and poor people. While discussing land holding structure in rural India the above table shows the proportion of landless, medium and large land holding households is decreasing and the marginal land holding households is increasing since 2004-05. NSSO 69th round data reveals that 0.0005 to 0.40 hectare land holding households (50.31%) are found higher in rural areas followed by 0.41 to 1.00 hectare (17.36%) all these are fall under the marginal land holding households (< 1ha) in rural areas. Only 0.31 percentage are landless, 10.98 percentage are found as small farmers (1-2 ha), 6.38 percentage are found under semi medium (2-4 ha), 2.42 percentage are found under medium (4-10 ha) and 0.32 percentage found under the large land holding households (>10 ha) in rural India (IDFC,2015). In rural areas, tribal and poor people are largely dependent on the forest resources for their
20 Ojha & Mohapatra / State of Livelihood Capitals in Rural India daily need and income. As estimate shows, 257 million rural people and 27 percent of the total population of India depend on forest for non-timber forest product for their subsistence and for daily income (Mallik, 2000; Pandey et al, 2016) and another estimate by Biswas (2003) shows that 70 % of Indian rural population depend upon forest for their daily livelihood activities. So it is quite clear that forest and land is significantly important than other capitals in form of employment generation among the rural communities in India. Despite of forest degradation and soil erosion, government have been implementing various programmes, policies and projects to strengthen the existing natural resources in rural areas; some of these are Gramin Bhandaran Yojana, Forest Right Act, PESA Act etc. in rural and Tribal areas. Social Capital In the livelihood analysis social capital is an abstract entity and intangible assets. It means availability of social resources upon which the livelihood outcome of individual or household is drawn. It also regards as the software of human communities and central toall other capitals assets (Mishra et al, 2016). Sometimes it is explained as the ‘politics of life’ and theessential elements are network, connectedness, co-operation, trust, collective representation, mutual support, participation, patronage, neighborhoods, leadership etc. (Kamil and Rashid, 2011; Mohapatra 2016), Reddy and his collegesrepresent migration pattern as a component of social capital. Generally, it is the ability of individual to secure benefits by virtue of members in different social group, network and structure and it is the mutual relationship within household members, institutions and communities. These ties and relationships among the members and community can be seen as an investment in gaining future livelihoods (Akki and Reddy 2015; Ellis, 2000). Table 1 Land Holding Structure in Rural India (in Per Cent) on the basis of NSSO Surveys (2004-05: 61st Round, 2011-12: 68th Round) Sl No. Land Holding Size 2004-05 2011-12 1 Landless 1.01 0.31 2 0.001 to 0.004 8.83 6.21 3 0.005 to 0.40 Marginal 44.05 50.31 4 0.41 to 1.00 16.02 17.36 5 1.01 to 2.00 Small 10.28 10.98 6 2.01 to 4.00 Semi-Medium 6.92 6.38 7 4.01 to 10.00 Medium 3.39 2.42 8 Above 10.01 Large 0.59 0.32
Source: India Rural Development Report, 2013-14
21 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Rew and Rew (2003) further add that livelihood were completely ways of life that are socially constructed. Indian rural society found as one of the example of demographical shift. The decline of joint family and rise of nuclear family is one of the characteristic of that demographical shift. Now-a-days the rural household size is decreasing; the data shows 50 percent of rural households found lower than having 4 persons. (IDFC, 2015) as a result cooperativeness among family member has been decreasing. The major cause of demographical shift and rise of nuclear family in rural India is lack of employment and it has raised the migration rate in rural areas. At the same time unemployment, raise of migration, industrialization, urbanization leads to increases of nuclear families in rural areas. NSSO 64th round (2008) data reveals that 325 million rural people and one third of total population in India are migrated from their place to other areas and among them 55 percent migrated for employment purposes in rural areas. (Hazra, 2012). As occupation plays a vital role in determining their livelihood status, those rural households adapted migration as an occupational strategy in off-seasons helps in developing social networks in the workplace, which helps them to build co-operation between fellow workers, contractors and people nearer to the place and it leads to further finding out work for their livelihood. Another major element of social capital in rural areas is group formation and in India 79.6 lakh Self Help Groups (SHG) are operating with the involvement of 9.7 crore people with active bank linkage. Among all the groups 90 percent are women based group. (Hazra, 2013) These SHGs have emerged as an alternative paradigm for the empowerment of rural women and eradicating rural poverty in India. For the development of social capital among rural people government, civil society, volunteer organization are continuously engaging themselves in implementing the programmes and projects, some of the projects are National Rural Livelihood Mission, Swarnajayanti Gram Swarozgar Yojana, National Service Scheme and so on for the upliftmnet of rural people. Conclusion Rural development in India is largely based on the programmes, plans and policies. The main objectivity of these plans, programmes and policies are to strengthen and sustain the livelihood structure of rural people. The livelihood enhancement is largely based on its capital structure improvement. Though the government has been implementing various rural development programmes on the basis of livelihood capitals, but the effectiveness of all programmes remains lagged behind among them. But in recent decade, the structure of livelihood capitals in rural India have been found to be increased day by day. In Human capital: education attainment increased and poverty level decreased; in Physical Capital: basic infrastructure increased i.e. road, housing, electricity, toilet; in Financial capital: accessibility to banks and saving though increased but with a slow pace; in Natural Capital: landless, medium and large land holding households is decreasing and the marginal land holding households is increasing; and in Social capital: migration and formation of SHGs in rural region increasing in India. However, now days the major concerns on livelihood capitals in rural India are degradation of natural capital i.e. forest resources, soil erosion which is the base for the rural livelihood in India and next to eradication of poverty by generating employment and educational attainment. In spite of
22 Ojha & Mohapatra / State of Livelihood Capitals in Rural India enormousspread of banking services in rural areas still non-institutional services play a major role in rural financing which is another hurdle in rural area. Though migration has become the source of getting employment in rural community through networking but simultaneously it threatens to enhance the social capital at the family level. Lastly there should be proper implementation of programmes and plans in rural areas for the capital enhancement and for the overall rural development in India. References Abass, Kabila et al. (2013). Household Responses to livelihood transformation in Peri-Urban Kumasi. Journals of Sustainable Development, 6 (6),122-136. Akki, M. J. and S. Reddy (2015). Livelihood in India: Ann Overview, Indian Streams Research Journal, 4 (12), 1-4. Biswas, P. K. (2003). Forest, People and Livelihoods: The Need for Participatory Management, the paper was presented at XII World Forest Congress, Quebec City: Canada. Chamber, R. (1983). Rural Development: Putting the Last First, England: Longman Scientific and Technical. Chambers, R. and Gordon, C. (1992). Sustainable Rural Livelihoods: Practical Concept for the 21st Century, Institute for Development Studies: Discussion Paper 296, UK: Brighton. Ellis, F. (2000). Rural livelihoods and diversity in developing countries. Oxford: Oxford University Government of India. 2011 Census Report. Government of Orissa (2012). Orissa Economic Survey 2011-12, Bhubaneswar: Planning and Coordination Department. Hazra, A. (2012). Rural India: Still Floating Towards Cities,Kurukshetra, February, 3-5. Hazra, A. (2013). Adding New Dimensions to Sustainable Rural Growth, Kurukshetra, July, 3-4. IDFC, (2015). Status of Rural Development: An Update. In IDFC (Eds.) Indian Rural Development Report 2013- 14, New Delhi: Orient BlackSwan Mallik, R. M. (2000). Sustainable Management of Non-timber Forest Product in Orissa: Some Issues and Options. Indina J.Agric. Eco., 55: 384-397. Meher, R. (2007). Livelihood, Poverty and Morbidity: A Study on Health and Socio-economic Status of the Tribal Population of Orissa. Journal of Health Management, 9(3), 343-367. Mishra, A. K. et al. (2016). Interrogating Livelihood among Tribals: A case study from Odisha. Social Vision, 3 (2), 19-31. Mishra, P. R. (2009). Coal Mining and Rural Livelihood: A Case of the Ib Valley Coalfield, Orissa. Economic and Political Weekly, 44 (44), 117-123. Mohapatra, B. P. (2016). Livelihood Status among Marginalised Community (SCs and STs): A Study of Parajapondi Village of Koraput District, Odisha. In Sheeladitya Paul and Subikash Chowdhury (Eds) Issues in Rural Livelihood, (pp:11-28). Kolkata: Progressive Publishers. Pandey, A. K. et al. (2016). Non Timber Forest Products (NTFPs) for Sustainable Livelihood: Challenges and Strategies. Research Journal of Forestry, February, 1-7.
23 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Paul, S. K. (2015). Rural development Concepts and Recent Approaches. New Delhi: Concept Publishing Company Pvt. Ltd. Reddy, V. R et al. (2004). Participatory Watershed Development in India: can it Sustain Rural Livelihood?. Development and Change, 35 ( 2), 297-326. Rew, Alan and Martin Rew ( 2003). Development Models ‘out of place’: social research on methods to improve livelihoods in eastern India. Community Development Journal, 38(3), 213-224. Scoones, Ian (1998). Sustainable Rural Livelihoods A Framework For Analysis. Institute of Development Studies: Working Paper 72. Sharma, G. (2015). Migration for (un) Employment? The Impact of Rural Out Migration in Rural India: A Case Study of North Bengal Region of West Bengal. In Gopal Sharma (eds.) Rural development in India: Issues and Challenges (pg. 214-232). New Delhi: Abhijeet Publications. Singh, Abha and B.N. Sadangi (2012). Livelihood Patterns and Resources Base of Tribals in Koraput and Rayagada District of Odisha. Indian Research Journals of Extension Education, 1, 307-312. Singh, K. (2009). Rural Development Principles, Policies and Management. New Delhi: Sage Publication India Pvt Ltd. Srinivasan, N. (2016). State of Rural Finance in India. New Delhi: Oxford University Press.
24 A STUDY OF CHANGING SOCIAL STRUCTURE ON THE MENTAL HEALTH OF THE AGED IN RANCHI TOWN Dr Arpita Roy* Nina Piyali Gupta** Abstract The present study was conducted on the aged, both male and female, to examine the effect of changing social structure on the mental health by administering the GDS scale, developed by J.A.Yesavage and others in 1982 at Stanford University The result indicated that in India the traditional norms and values had laid stress on the fact that respect and care should be provided for the elderly. The joint family system and the social structure prevalent before the advent of the change in the present social structure provided an appropriate environment in which the elderly spent a more secure life. It was the advent of modernization, industrialization, urbanization, occupational differentiation, education and degeneration of moral values that replaced the traditional norms and in its place there were modern thoughts which eroded the authority previously vested to the elders. There is a marked decline in the respect for the elders among the younger generations. There is a rapid growth in the number of older population which has posed many issues likely to affect the elderly. India has started to perceive the gravity of these issues. Severe economic and social problems seem to have become a great source of worry for the elderly along with absence of ensured and sufficient income, ailments of various kinds, mental problems which are the major issues that the elderly have to struggle with today. Keywords : Elderly, Living Arrangements, Dependency, Depression Introduction Ageing is inevitable and unavoidable, however, modern science and modern technology is trying to understand the process of ageing and its impact on the human body through continuous research in this field. To a large extent medical science has helped in understanding as to the conditions that leads to the slowing down of this process of aging and also the ways to overcome the many age related diseases. The increase in the aged population explosion is not just limited to the developed countries but it is also seen in the other less developed countries. The advances in science technology and medicine have led to the reduction in infant and maternal mortality leading to a growth in population eventually leading to growth of aging populace. The world is growing old due to a combination of declining fertility and extending longer lives. The global bloom seen in ageing is probably the most important phenomenon in the present time. People aged 60 years and older comprise 0.9 billion of the world’s population. In the latter half of the last century the world’s developed nations completed a long way of demographic transition. Demographic transition is a shift from a period of high mortality, short lives and large families to a state of longer life expectancy, lesser children and smaller families. Modern medicine has contributed to the reduced risk of contagious disease and a prolonged life. Very low birth rates and resultant of the youth have led to an increase in population of retired seniors. In 2000
* Associate Professor and Head of Department of Home Science, Marwari College, Ranchi. ** Asst. Professor, Dept. of Clinical Nutrition and Dietetics, Marwari College, Ranchi. 25 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 approximately 605 million people were 60 years old or older than 60 years. By 2050 the number is expected to be close to two billion. By that time, senior citizens will outnumber children of fourteen years and under, for the first time in the history of mankind. Population aging has many socioeconomic and health related consequences including dependency of the aged on the society. India is the second most populous country and it has experienced a change which is very dramatic in nature in the demographic transition in the past 50 years where there has been a tripling of population over the age of 50 years (Government of India 2011). There is a change in structure and the function of the family and its implication for the elderly in the family. A growing concern in India is that there is a changing kinship bond and family bonds. The family and kinship bonds offer social security for the care of the old age has disintegrated over the years and this has lead to the weakening of these bonds over the past decades. The weakening of such age old bonds was caused by the pressure created by industrialization, urbanization, modernization and value change. In traditional agrarian Indian culture elders are revered and respected in the society and old age was never considered as a problem. It was a natural phenomenon of the state of the body and there was a natural shift of position of the elderly in the family. There was a strong social support and regard for the elder and elder care was considered as the integral part of the duties of the household. The elderly not only participated in religious and social activities but also their counsel was highly valued in familial and community matters. Their power and status in the family were reinforced by their rights over finances and property. Due to rapid social transformations in the society the traditional joint family system has dwindled and have been showing signs of disintegrating at a very fast pace. About 65% of the aged had to depend on others for their day to day maintenance. This situation was worse for elderly females with about only 14% to 17% being economically independent in rural and urban areas respectively while the remaining are dependent on others partially or fully. The elderly males were much better off as majority of did not depend on others for their livelihood. Among economically dependent elderly male, either rural or in urban part of the country about 6-7% were financially supported by their spouses, almost 85% by their own children, 2% by their grand children and 6% by others or by government aids. Among the economically independent male more than 90% were reported to be living with one or more dependents while among economically independent women about 65% were having one or more dependents. As people live longer and into much advanced age (say 75 years and over) they need more intensive and long time care which in turn may increase the financial stress in the family. In adequate income is a major problem of the elderly in India. The most neglected are those who are not capable of having productive assets have little or no savings or income from investments made earlier ,have no pension or retirement benefit and are not taken care by their children or they live in families that have low and uncertain income and a large number of dependents. The rapid population ageing is bringing about a social change along with economical and cultural changes. A holistic approach to this section of the population is needed to effectively solve the emerging problems of the aged. The different economic situations and adverse conditions are having a profound effect on the health status of the aged which may cause physiological as well as psychological problems which later on would become very difficult to cope with as the whole 26 Roy & Gupta / A Study of Changing Social Structure ... socio economic status would change. The economic conditions of the aged in the consequence of a number of changing trends in living arrangements ,declining fertility leaving fewer children available to take care for older parents, rural to urban immigration for employment that separates the families and changing expectations regarding intra family obligations. Recent survey confirms this shift in attitudes with a 40% decline in the share of adult children who said caring for their elderly parents was becoming difficult for them. Many aged do not receive any benefit in the event of their retirement. Elderly people are highly prone to mental morbidities due to ageing of the brain, problems associated with physical health, cerebral pathology, socio-economic factors such as breakdown of the family support systems, and decrease in economic independence. The mental disorders that are frequently encountered include dementia and mood disorders. Other disorders include neurotic and personality disorders, drug and alcohol abuse, delirium, and mental psychosis. The rapid urbanization and societal modernization has brought in its wake a breakdown in family values and the framework of family support, economic insecurity, social isolation, and elderly abuse leading to a host of psychological illnesses. In addition, widows are prone to face social stigma and ostracism. Thus the present study aims to understand the effect of the social changes on the aged which is adversely reflected on their mental health. Objectives of the Study 1. To study the changes in the social structure and dependency of the elderly in a family environment. 2. To study the mental health of the elderly as a result of the change in the social structure. Hypothesis: There is significant impact of change in social structure on the mental health of the aged. Design of the study: The present study was designed to investigate the mental health of the aged. A descriptive research design was adopted by the investigator to conduct the study. Sample: The sample of the present study comprised of 158 males and 142 females purposively selected from 14 wards of Ranchi town. Tools: Personal Data Sheet – A personal data sheet was prepared by the researcher herself for collecting relevant in formations and were grouped into many categories such as physical health, .interpersonal life, economic status, income, source of income, psychological health etc .The respondents were interviewed at their residence. Some aspects of personal and family such as family relations, personal satisfaction and general awareness of the aged were judged by observation, group discussion and informal interviews and discussion with subject, their spouse or friends. Geriatric Depression Scale – The GDS scale was developed by J.A.Yesavage and others in 1982 at Stanford University. It is a simple 30 items yes/no question that can be helpful in identifying possible depression among the elderly people. The simplicity enables the scale to be used with ill or moderately cognitively impaired individuals. The scale is commonly used as 27 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 a routine part of comprehensive geriatric assessment. One point is assigned to each answer and the cumulative score is rated on a scoring grid. The grid sets a range of 0-9 as “normal”,10- 19 as “mildly depressed” and 20-30 as “ severely depressed” Validity reliability – It was found to have 92% sensitivity and 89 % specificity when evaluated against diagnostic criteria. The validity and reliability of the tool have been supported through both clinical practice and research. Results and Discussion Table 1 reveals the living arrangements of the aged in terms of the type of family they live in .The table showed that 31.64 % of the male elderly respondents and 42.25 % lived in the joint family. It was seen that 46.20 % of the male respondents and 44.36% of the female respondents lived in a nuclear family whereas 12.65% of male and 13.38 % of females lived alone. The living arrangement reflected on the care taken by the family members and the kind of emotional and financial support they got from their family. The importance of family in the society is evident in the fact that family is the basic institution in the society which is structured to take care of the family members who are the part of the family. Family is a unique institution and it is the only institution other than religion which is formally developed in all societies. Family duties are the direct responsibility in society with rare exception. The most important function of family is to take care of children, infirm, disabled and the aged family members. The respondents living in the joint family had varied experiences regarding their relationship with their family members. Some of them were properly looked after whereas some of them were subjected to abuse by their family members. The respondents who lived alone were very vulnerable to assault by the antisocial elements and were seen to be mostly depended on the community or neighbors for support rather than the support by the family member. Table 2 shows the different groups of aged who live with their son or with their daughter or with both, son and daughter. It is seen that 74.32% of male and 69.23% of female live with their son. 10.81% male and 11.53% female live with their daughter. The other group, that is about 14.86 % male and 19.23 % female, live with both son and daughter. The table focused on the children living with the aged. An obvious difference is seen when the aged are living with their daughter rather than their son. The aged who live with their adult son have to deal with their daughter in law. The relation between the aged in laws and daughter in law is a very sensitive issue as well as complex in nature. It is often seen that the daughter in laws ill treat their in -laws and this lead to family discord. The aged living with their daughter are in much Table-1 Distribution of respondents by their type of family structure Family structure Male Female Respondents Percentage N=158 N=142 M F Joint family 65 60 31.64 42.25 Nuclear family 73 63 46.20 44.36 Alone 20 19 12.65 13.38 TOTAL 158 142 100 approx 100 approx
28 Roy & Gupta / A Study of Changing Social Structure ... Table- 2 Distribution of respondents according to their children living with them Family member Male Female Respondents Percentage living with elderly N=158 N=142 M F Son 55 36 74.32 69.23 Daughter 8 6 10.81 11.53 Son and Daughter 11 10 14.86 19.23 With spouse 41 39 25.94 27.46 With other 23 32 14.55 25.53 members Living alone 20 19 12.65 13.38 TOTAL 158 142 100 approx 100 approx better in better environment as it is the attachment of the daughter which makes the life of a senior more tolerable. Some of the aged live with their daughter and son in those situations when neither is married or one of them is unmarried. The aged has to adjust himself in the house of his son and has to follow the lifestyle of their son. The senior citizens prefer to live with their daughter rather than with their son but the social norms forces them to stay with their son even if the situation at home is intolerable and causes distress to the elderly. The daughter and her spouse are more thoughtful in most of the cases and they are more sympathetic to the failing cognitive functions and health of the aged. Table 3 reflects on the economic dependency of the aged on the other members of the family. It is seen that 48.10% male and 73.23% female are fully dependent financially on their children or other members of the family. The group which was partially dependent comprised of 39.24% male and 15.49% female. The group that was not dependant comprised of 12.65% male and 11.26% female. The importance of this relationship is reflected on the mental and physical health of the aged. It also depended on the size of the family and occupations of the family members. In this study it was found that a large number of respondents belonged to the middle size family and 39% of those respondents were fully dependent on their family members. Almost the same figure, that is 40% of the respondents belonging to the middle size family, were partially dependent on their family members. Only 21% of the respondents in this group were not dependent on the family members. The table revealed the situation of the elderly as their dependency status clearly reflected on their economic conditions .The women were seen to be more dependent than the men and they had to face dire situations due to this condition. Some were dependent due to their inability to manage their own finances and they seemed to be the most deprived of the group. The situation of some of the aged were appalling as they were subjected to physical as well as mental harassment due to their dependency on their children or relatives. Table 4 analyzed the mental condition of the respondents and found that 23.41% of males and 40.84% of females suffered severe depression. The percentage of respondents who suffered from mild depression was male 39.24% and female 47.18%. The percentage of respondents
29 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Table- 3 Distribution of respondents according to their economic dependency Dependency Male Female Respondents Percentage N=158 N=142 M F Fully dependent 76 104 48.10 73.23 Partially 62 22 39.24 15.49 dependent Not dependent 20 16 12.65 11.26 TOTAL 158 142 100 approx 100 approx who were normal was 37.34% male and 11.97% female. The analysis revealed the fact that along with physical problems, the aged has to come to terms with their failing memory, their inability to recognize things or persons, their problems with their cognitive faculty, which led to depression. The aged from the low economic status were found to be in very bad condition physically as well as mentally. They had mild to severe depression and also suffered from other mental problems. They showed signs of dementia as they could not recall things even from their recent past .The other sector who showed depressive characteristics were the female respondents and it was more evident in the widows. The widows were the most neglected of all the aged as they had no economical support to carry them through their old age. Conclusion The present study reflects o the mental condition n the form of depression of the aged due to the breakdown of the traditional living arrangements and the increase of their dependency o
Table- 4 Distribution of respondents according to their depression Depression Male Female Respondents Percentage N=158 N=142 M F Severe 37 58 23.41 40.84 Mild 62 67 39.24 47.18 Normal 59 17 37.34 11.97 TOTAL 158 142 100 approx 100 approx their children and the concerned people. Their depression reflects o their helplessness in their changing social and economic status and their inability to cope with the fact that age has limited their physical and mental prowess. References Andrade, C.; Radhakrishnan, R. (2009). “The prevention and treatment of cognitive decline and dementia: An overview of recent research on experimental treatments”. Indian JPsychiatry. Barua, A.; Mangesh, R.; Kumar, H.H.; Mathew, S. (2005). “Assessment of the domains of quality of life in the geriatric population”. Indian J Psychiatry; 47,157–159. 30 Roy & Gupta / A Study of Changing Social Structure ...
Dunkin, J.J.; Kasl Godley, J.E. (2000). “Psychological changes with normal ageing”. Lippincott, Williams and Wilkins. Gavrilov, L.A.; Gavrilova, N.S. (2001). “The reliability theory of ageing and longevity”. Journal of TheoriticalBiology ,Elsevier Press ,USA. (4); 527-45. Khandelwal, S.K. (2003). “Mental health of the older people”. In Dey editor, Ageing in India, Situation Analysis and Planning for the Future, New Delhi:Ramko press 2003; 43-47. Mathuranath, P.S.; Cherian, P.J.; Mathew, R. Kumar, S. et. al. (2009). “Dementia in Kerala, South India: Prevalence and influence of age, education and gender”. Int J Geriatric Psychiatry.; John Wiley and sons , USA ; 25; 290–297. Mini, G.K. (2008). “Socioeconomic and demographic diversity in the health status of elderly people in a transitional society, Kerala, India”. Published online in. Journal of Biosocial Science. 10-14. Mutharayappa, R.; Bhat, T.N. (2008). “Is lifestyle influencing morbidity among elderly?” Journal of Health Management”; 10(2); 203–217. Patel, V.; Prince, M . (2001). “Ageing and mental health in developing countries: Who Cares?” Qualitative studies from Goa, India, Psychological Medicine Medknow publications India. 31; 29-38. Rajan, S.I.; Kumar, S. “Living arrangements among Indian elderly: New evidence from National Family Health Survey”. Economic and Political Weekly India: SameekshaTrust; 38(3); 75–80. Rajkumar, A.P.; Thangadurai, P.; Senthilkumar, P. Gayathri, K. Prince, M. Jacob, K.S. (2009). “Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community”. Int Psychogeriatr. Rajkumar, A.P.; Thangadurai, P.; Senthilkumar, P.; Gayathri, K. et. al. (2009). “Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community”. IntPsychogeriatr.Cambridge University Press UK. 21; 372–378. Roy Kakoli and ChoudhariAnoshua , (2008). “Influence of Socioeconomic Status and Empowerment on Gender Differences in Health and health care Utilization in Later Life: Evidence from India”. Jn. Social Science and Medicine. Elsivier, Netherlands , no 9; 51-62. Shaji, K.S.; Smitha, K.; LalK.P.; Prince, M. (2002). “Revealing hidden problem”. An evaluation of community dementia case finding programme from India dementia research work. Int Journal Geriatric Psychiatry. Shaji, K.S.; Arun Kishore, N.R.; Lal, K.P.; Prince, M. (2002). “Revealing a hidden problem”. An evaluation of a community dementia case-finding program from the Indian / dementia research network”.Int J Geriatr Psychiatry. Shankardass, M. (2009). “No one cares about elder abuse in India”. One World South Asia. Available:http:/ /southasia .oneworld .net/opinioncomment /no-one-cares-about-elder-abuse-in-india. Siva Raju, S. (2000 ). “Ageing in India: An Overview in Gerontological Social Work in India”. Murli Desai and Siva Raju (eds) ,B.R. Publishing Co., New Delhi; 214-225. Vijay Kumar, S. (2003). “Economic Security for the Elderly in India: An Overview”, An Aging India: Perspectives, Prospects and Policies, The Haworth Press, New York; 45-65. Zakir Husain, and Saswata Ghosh, (2011). “Is Health Status of Elderly Worsening in India? A Comparison of Successive Rounds of National Sample Survey Data”. Journal of Biosocial Science 43, no. 2 (2011); 211-230.
31 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 FACTORS PREDICTIVE OF PREFERRED PLACE OF NURSING HOME FOR END-OF-CARE AND DEATH IN COMMUNITY-DWELLING FAMILY CARE GIVERS OF FRAIL ELDERLY IN EAST ASIA Prof. Jung-Nim Kim * Abstract There has been little investigation of the factors affecting preferred place of nursing homes (NHs) for end-of-care and death for the frail elderly by their family caregivers. To investigate factors influencing preferred place of NHs for end-of-care and deathas the actual place in community-dwelling of family caregivers for frail elderly people in East Asia (Japan, South Korea, China, and Taiwan). The subjects of the sample were the primary family caregivers who were live with the frail elderly in order to provide home care and support in Japan, Korea, China, and Taiwan. The data was collected in 2013 using a questionnaire through the placement method (in Japan) and via face-to-face interviews (in Korea, China, and Taiwan). The study subjects included 783 Japanese, 611 Koreans, 800 Chinese, and 555 Taiwanese people. A mixed- effect model was used to examine the preferred place of NHs for end-of-care and death associated with individual level and countries and region level in East Asia. The study found that family caregivers for frail elderly with a higher dementia risk received many different types of care support from professional care workers and nurses. Those frail elderly in strong economic situations were significantly associated with NHs as the preferred place of end-of-care and death in East Asia. Family caregivers who live in countries and region with the highest GDPs per capita were positively and significantly associated with NHs as the preferred place of end-of-care and death in East Asia. In addition, family caregivers who received many different types of care support from professional care workers and nurses and who live in countries and region with public LTC systems were positively and significantly associated with NHs as the preferred place of end-of- care and death for their relatives. While preferred place for death and end-of-care is important to the frail elderly, other factors are important in deciding on preferred place of end-of-care and death; these can differ by individuals’ economic situations. Efforts to evaluate and improve frail elderly and family caregivers’ experiences at the end-of-care must account for diverse places of death. Keywords : preferred place of death, nursing home, family caregivers, frail persons. Introduction The prevalence of frail elderly persons is growing in East Asia, and the family caregivers who live with the frail elderly are considering institutional carefor their relatives. Living innursing homes (NH)is particularly common for end-of-care among community-dwelling, frail elderly who were certified to be eligible for the long-term care (LTC) insurance system in Japan. According to 2015 Japanese governmental reports, frail persons (aged 40 and older)with certified levels of care needs and preventative care needs under LTCI were an estimated 6.01 million people and about52.1
* Prof. in psychology, Tokyo University of Social Welfare, JAPAN. E mail : [email protected] 32 Kim / Factors Predictive of Preferred Place... thousand of them live in special nursing homes; however, about 525 thousand of frail persons are placed on the waiting list for NHs services in 2014 (Ministry of Health, Labor and Welfare, 2015).These frail persons in NHs will disproportionately increase due to the Baby Boomer generation (those born between 1947 and 1949) who will reach the age of 75 and older by the year 2025 (Kim, 2015). At the same time, the Baby Boomers will face more need for end-of-life and death care than recent generations. On the other hand, in a survey of Japan’s population, the rate of deaths was 79.8% to 75.6% inhospitals andonly 2.1% to 5.3%in NHs,in 2005 and 2013 (Ministry of Internal Affairs and Communications, 2014), respectively. The rate of death is slightly decreased but still higher than in hospitals and slightly increased in NHs.However, if nothing changes demographically by the year 2030, 470 thousands people of 1.6 million of total deaths will not havea place of death (Ministry of Internal Affairs and Communications, 2014).Thus, the Japanese government has been trying to move the place of death of people from hospitals to NHs or private residences. Therefore, the government’s LTC system reforms in 2006 have provided end-of-life care allowance for NHs that have adopted a range of practices to meet the needs of residents at the end-of-care and death.Comparing the last quarter of the 20th century in Japan to East Asia, hospital deaths have increased and home deaths have reduced due to lower out-of-pocket medical costs through a public health insurance system implemented in 1961. Moreover, these costs have been paid by most of the frail elderly who were hospitalized patients because the national pension system was implemented in 1961.In addition, the Japanese government has supported institutional palliative care services called palliative care units initially, which have been covered by National Medical Insurance since 1961. In contrast, the Korean, Chinese, and Taiwanese governments have partially implementeda social security system in recent years. Thus, elderly people who have a higher socio-economic status have more often chosen to die in hospitals over homes and NHs.A home death is still a distant reality for the majority, even though evidence shows that the home is the most commonly preferred place to die in Japan. However, the death rate in hospitals and NHs of Korean, Chinese, and Taiwanese elderly will be increasing and home death proportions will be falling fastest in the oldest age groups because of the implemented national pension system and national health insurance system. The Japanese government has surveyed preferences for end-of-care and death locations among the general population every 5 years since 1998. The majority of people would like to die at home.The latest survey in 2012 revealed that 54.6% of Japanese (aged 55 and older) would prefer to be at home as place of end of-care and death;27.7% preferred hospitals, and only 4.9% selected NHs when they wereterminally ill (Cabinet office, Government, 2012). This is an important aspect of place of death, but preferences around place of death seem fluid and are challenging to elicit and record (Munday et al. 2009).The survey also found that 69.3% who wanted to die at home were able to achieve their preferences when9.5% of patients changed their preference for place of death (All et al. 2015).A shift in preference for place of death may be influenced by care at home breaking down or failing, particularly good (or poor) experiences in hospital or inpatient hospice, physical symptoms or perception of family burden (Higginson et al. 2013).Although, family care givers may not be give place for dying at their homes for frail elderly,such decision making forplace of death is important togive good qualityend-of-careand emotional support (Kim, 2016). Direct enquiry and identification of preferences for place of end-of-life care is associated with patients achieving their preference
33 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 place for death (All et al. 2015). In addition, NHs have been playing an important role for older people at the end of life (Percival and Johnson 2013);however, NHs as the referred place for death is less popular than home and hospital approaches. In recent years, numerous studies have suggested that home death is the most common choice patients express (Munday and Shipman,2007; Munday et al. 2009). The factors of health status, participation in volunteer activities, and preferred spouse as the caregiver (Ohmachi et al. 2015)were significantly affected preference for place of death at home.Further, the presence of visiting nurses in homes (Sasaki et al. 2008) as well as the preferred place for death of both patients and caregivers (Akiyama et al. 2007) significantly affected preference for place of death at homes.Many outcomes found that home death was related to higher socio-economic statusbecause it is a familiar environment where they maintain control and greater freedom than in hospitals or even inpatient hospices (Higginson et al. 2013). However, culture and ethnicity affect place of death. Pakistani, Indian, Bangladeshi, Black African, Black Caribbean and Chinese patients were all significantly more likely than White patients to die in hospitals (Coupland et al. 2011). Furthermore, there are different forms of preference for place of death. Fukui et al. (2011)indicated that preference of place for hospital, palliative care unit, or nursing home was correlated with visiting hospital, experiencing home death of relatives, and lower home palliative care costs. It is limited tothe aspect of general people and patients’ autonomy to promote aging in a place, butpreferred place of death is likely to be influenced by several factors. Despite enthusiasm for strengthening relationships among family caregivers to promote aging in a place, there have been very few studies on how family caregivers offrail elderly with advanced dementia and lower levels of ADLs as well as how economic status and care services can enhance aging in NHsin East Asia, even though the national LTC systemhas an ongoing care delivery process in China and Taiwan compared to Japan and Korea. Aim of the Study This study aimed to address which factors are associated with the preferred forend-of-care and death in NHsas the actual place of end-of-carefor their frail elderly by family caregivers in East Asia. Hypothesis The previous research on aged middle and older persons, and patients’ care preferences, no known study examines family caregivers’ preferred place of end-of-care and death for the frail elderly in East Asia. Therefore, the study examined a sample of family caregivers who live with frail elderly persons in three countries and one region in East Asia.Based on the aforementioned studies, the general hypothesis this studytested was:H1–Family caregivers of frail elderly with anadvanced dementia risk and low-level activities of daily living (ADLs) are more likelyto prefer place in a NH asthe actual place of end-of-care for the frail elderly;H2 –Family caregivers who receiving may different types of care from care works and nurses are less likely to prefer a place of end-of-care and deathin a NH asthe actual place of end-of-care for the frail elderly; H3 – Family caregivers withhigher socio-economic status of frail elderlyare more likely to prefer place of end-of-care and death in a NH for the frail elderly; and H4 - Family caregivers who livein countries and region with the highest GDPper capita (gross domestic product)and has public LTC system are more likely to prefer aplace of end-of-care and death in a NH asthe actual place of end-of-care for the frail elderly.
34 Kim / Factors Predictive of Preferred Place... Design and Methods 1) Data and subjects Thesubjects of the sample were familycaregivers who live with the frail elderly and gave care support at homesin Japan, Korea, China, and Taiwan. Because patients’ and families’ preferences for place of end-of-care and death are often not met, more patients wish to be cared for and to die at home than family caregivers would prefer (Higginson et al. 1999).The sample survey of frail elderly was conducted using a list of certification care levels of elderly people in Japan and Korea. However, In China and Taiwan, the home-bound elderly peoplehave a need for support and care when they choose to leave their homes.The datawas collected through the placement method (in Japan) and via a face-to-face interview method (in Korea, China, and Taiwan) using a structured questionnaire from October to December 2013.The study subjects included 783 (92.9%) Japanese, 611 (78.1%) Korean, 800 (88.9%) Chinese, and 555 (80.2%) Taiwanesefamily caregivers. 2) Model for Analysis Dependent variable The dependent variable is at the individual level and assesses preference place of death. The item asks, “if the frail elderly livingwith you became seriouslyill and medicine couldn’t treat them anymore, which place would youpreferfor end-of-care and death?”. The categories included a 7- point scale (current home, adults’ children homes of frail elderly, relative homes, hospital, palliative care hospice, long-term care facility, and residence type home”, or other). In this study, preferred place of death is examined with two indicators; whether or not the family caregiverpreferred the NH as the actual place of end-of-care and death for their relativesand a dummy variable is used (0= non NHs, and 1=NHs). Independent variables Individual level Atthe individual level, the study includesseven measures of age and sex (1 = female, 0 = male) of frail elderly and family caregivers, the length of time for care and support, ADLs, and dementia status of frail elderly byfamily caregivers. Specifically, the study examineddisabilitiesfor activities of daily living (ADLs), and this scale contained 8 itemsto measure residents’ functional impairment (e.g., dressing, bathing, eating, getting in or out of bed, toileting),and responsesforeach item were no difficulty, some difficulty, a lot of difficulty, and unable. I computed the sum of all eight items and higher scores representedsignificant difficulty.The symptoms of dementia status contained 12 items on impairments and difficulty in (e.g.thinking, communicating, behavior,reasoning, andshort-term memory).I computed the sum of all of eight items and higher scores represented a significant difficulty and impairment.Finally, whether or not the frail elderlyreceived care support from professional care workers or nurses contained 14 itemson types of care services (e.g.,moving in house, dressing, bathing, eating, toileting, cosmetic cleaning) in their home (1 = yes, 0 = no). I computed the sum of all 14items and higher scores represented frail elderly receiving many different type of careservicesfrom professional workers or nurses.The current economic and living conditionstatus of the frail elderly was measured using a 5-point scale (very easy, easy, neutral, difficult, very difficult).
35 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Country and Region Level At the national level, the study included one measure of gross domestic product(GDP)per capita in 2015 in 3 countries and 1 region from the OECD, and whether or not a countries and regionhad a public LTC system (1 = yes, 0 = 1) Analysis Strategy: First, the study provideddescriptive analyses of all variables (Table 1). Second, the study displayed percentage ofrespondents by preferred place of end-of-care and death according to individual level and country and region level (Table 2) and percentage of preferred place of end- of-care and death by countries and region (Figure 1). Third, the study analyzes Pearson’s correlation coefficients for bivariate relationships between individual level and country and regional level predictors and the dependent variable (Table 3). Fourth, the study performed multilevel linear regression modeling to estimate the associations between individual level and country and regional level factors on preference for place of end-of-care and death for frail elderly (Table 4). Multilevel modeling is a preferred method for nested data structures, such as the sample analyzed here, which includes individuals nested within nations (Mair et al. 2015). This approach estimates variance at both the individual and national and regional level, which allows for more accurate estimation of coefficients and standard errors compared with ordinary leastsquares regression (Raudenbush & Bryk, 2002). Further, the study examined all of the final model results without outliers that score particularly high or low on key predictors or the dependent variable (e.g. Japan, Korea, China, and Taiwan). In the results section, the study describes the extent to which our findings remain robust and consistent after these tests. STATA software, version 13.0 was used. Ethical Consideration This survey was approved by the ethics committee of Tokyo University of Social Welfare. Results Descriptive Statistics The total case, means, standard deviation, min and max of all dependent, independent and control variables are shown in Table 1 and Figure 1. The majority of the sample of family caregivers who live with the frail elderly do not preferNHs for place of end-of-care and death for frail elderly and the mean was 0.14. A lot of frail elderly and family caregivers were female (60%, 70%) and the mean of age of frail elderly and family caregivers was 81.0, 55.23, respectively. The mean of current economic and living conditions of frail elderly was 2.91 and a majority of the sample had an average rate. About half of the frail elderly had low levels of ADLs and moderate symptoms of dementia. The mean ratio of health care needs was 4.85 years. The mean of frail elderly with perceived care service of professional care workers was 2.02. Two countries (Japan and Korea) in the sample have a public LTC program, and the mean was 1.51. Figure 1 shows the preferred placeof end-of-care and death of family caregivers forthe frail elderly.The proportions of preferred place of end-of-care and death for the frail elderlyat home were73.6% Chinese, 60.6% Taiwanese, 58.6% Korean, and 44.3% Japanese family caregivers. About a fourth of Japanese, a fifth of Korean and Taiwanese, and only 3% of Chinese family caregivers preferred NHs as a place for end-of-care and death.
36 Kim / Factors Predictive of Preferred Place... Table -1 Descriptive Statistics of all Variables (Countries and Region)
N Min Max Mean SD Dependent variables (individual level) Preference place for death 2684 0 1 0.14 0.35 Level 1: individual level Health care needs and economic conditions Current economic and living conditions 2737 1 5 2.91 0.80 Sum of ADL (8 items) 2744 2 24 14.49 5.09 Sum of dementia (16 items) 2736 1 32 28.65 4.44
Length of health care needs 2639 0 85 4.85 7.32 Covariates Sex of frail elderly 2709 1 2 1.60 0.49
Age of frail eldelry 2555 65 103 81.00 7.85 Sex of family caregivers 2698 1 2 1.70 0.46 Age of family caregivers 2676 20 98 55.23 14.54 Perceived care services by professonal workers 2728 0 12 2.02 3.38 Level 2: country and region level Has public LTC (1 = does not) 2753 1 2 1.51 0.50 GDP per person in 2015 ($) 2753 7989 32485 22121.88 9712.82 China 800 Taiwan 559 Japan 783 Korea 611 Table 2 indicates the preferred place of NH of end-of-care and deathfor the frail elderly. At the individual level, the preferred place of NH for end-of-care and deathwas associated with low levels ofADL rather than high levels of ADL of the frail elderly (p<.01). Also, preference for end-of-care and death in NHs was greater in frail elderly with advanced cognitive impairment dementia compared to mild cognitive impairment dementia (p<.01). The preference for end-of-care and death in NHs
Figure 1 : Preferred Place for Death
37 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 was greater in family caregivers who did not receive in-home services for frail elderly by professional careworkers and nurses compared to those who received many different type of service by professional careworkers and nurses (p<.01). In covariates, preference for end-of-care and death in NHs was more likely in 80 years and over of frail elderly (p<.01), younger ages of family caregivers (p<.01), and female family caregivers (p<.01). At the country and regional level, family caregivers live in countries with a public LTC system (p<.01) and $32,485.00 GDP per person in 2015 (p<.01) preferred NHs for end-of-care and death for frail elderly. Table-2 Preferenced place of claracteristics between the NH and non-NH group
38 Kim / Factors Predictive of Preferred Place... The output two-way ANOVA Correlations of all variables (Table 3) reveal generally weak correlations among individual level predictors although moderate associations.Frail elderly having at least one ADL limitation was moderately associated with preferred place of NH for end-of-care and death (p<.01), female (p<.05), andage of frail elderly (p<.01), and lowest rates of current economic and living conditions (p<.01). As expected, moderate negative associations were present between frail elderly with mild dementia and preferred place of NH for end-of-care and death (p<.01), female (p<.01), age of frail elderly (p<.01), and ADL (p<.01). Not surprisingly, a moderate positive associationwas present between received in-home services for frail elderly by professional careworkers and nurses (p<.01) and female and age of frail elderly (p<.01), female and age of family care givers (p<.01), at least limited on ADL (p<.01), and at least limited dementia (p<.01).Age of frail elderly, age and female of family caregivers was significantly correlated withpreferred place of NH for end-of-care and death for frail elderly (p<.01), respectively. At the national level, there existed strong correlations between living in a countries and regions with a public LTC system and preferred place of NH for end-of-care and death (p<.01), age of frail elderly (p<.01), age of family caregivers (p<.01), at least limited on ADL (p<.01), at least limited dementia (p<.01),received in-home services (p<.01), expected, GDP per person in 2015 (p<.01), Determinant factors associated with preferred place of NH of end-of-care and death: the outcome of multiple regression analysis Multilevel liner regression models of individual-level and country and region-level predictors of preferred place of NH for end-of-care and death for the frail elderly based family caregivers are presented in Table 4. At the individual-level, the symptoms of dementia status of the frail elderly were initially marginally associated with higher preferred place of NHsfor end-of-care and death in all models (p<.01), and this relationship becomes significant even though after adjustment for covariates in all models (p<.01). This means that family caregivers of frail elderly with higher
Table 3. Correlation of All Variables (N=2,684)
1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) Level 1: individual level 1)NH 1 Covariates 2)Sex of elderly .020 1
3)Age of frail eldelry .092** .141** 1
4)Sex of family caregivers .068** .040* .090** 1
5)Age of family caregivers .122** -.034 .304** .082** 1 Health care needs and economic conditions
6)Current economic and living conditions .004 -.032 -.005 .014 -.077** 1
7)Sum of ADL (8 items) .136** .043* .244** .112** .316** -.172** 1
8)Sum of dementia (16 items) .123** .077** .170** .095** .162** -0.123 .369** 1
9)Length of health care needs .005 .010 .100** .011 .099** -.041* .180** -.055** 1
10)Perceived care services by professonal workers .108** .068** .053** .077** .132** -.044* .400** -.256** .008 1 Level 2: country and region level
11)Has public LTC .164** .090** .230** .276** .498** -.160** .373** -.213** .018 .246** 1
12)GDP per person in 2015 ($) .220** .096** .288** .306** .534** -.174** .455** -.215** .089** .233** .839** 1
13)Japan=1, other country=0 .151** .045* .287** .178** .363** -.117** .159** -.016 .119** -.188** .622** .673** 1
14)Tiwan=1, other country=0 .038* -.006 -.024 -.015 -.072** .021 .081** -.001 .071** .062** -.511** .009 -.318** 1
15)Korea=1, other country=0 .032 .060** -.039* .139** .206** -.065** .277** -.239** -.115** .502** .527** .279** -.337** -.270** 1 Note **p<.01 *p<.05
39 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 symptom dementia were preferred NHs for end-of-care and death for the frail elderly. However, received in-home services for the frail elderly by care workers and nurses was significantly associated with Preferred place of NHs of end-of-care and death for the frail elderly in all models (p<.05), and this relationship becomes significant after adjustment for covariates in all models (p<.05). This means that family caregivers who received many different types of in-home care service by professional care workers and nurses preferred NHsfor end-of-care and death for the frail elderly in East Asia. Frail elderly people who had a strong socio-economic situation were significantly associated with NHs as a preferred place for end-of-care and death by family caregivers in all models ((p<.01), but this relationship is not significant after adjustment for county and region- level (Model 5). Contrary to expectations, family caregivers of the frail elderly of ADLs and duration of long-term care needs were notsignificantlyassociated with NHs as a preferred place for end-of-care and death for frail elderly in all models.Although, the addition of covariates to the model did not improve model fit (Model 2), the study retains these adjustments due to their conceptual importance.
Table 4. Estimates of Preferred Place of death for Frail Elderly M odel 1 M odel 2 M odel 3 M odel 4 M odel 5 M odel 5
Fixed Effect C officient p C of p C of p C of p C of p C of p
Fixed effects
Level-1: individual level
Intercept .283 ** .260 * .105 * .146 .125 .249 *
Health care needs and economic situations The total score of AD Ls .001 .000 .000 .000 -.001 .000
The total score of cognitive dem entia .008 ** .008 ** .008 ** .008 ** .008 ** .008 **
Length of health care needs -.001 -.001 -.001 -.001 -.001 -.001
C urrent econom ic situation .011 ** .012 ** .010 ** .012 ** .018 .045 **
P erceived care services by professonal w orkers .021 * .022 * .022 * .022 * .020 * .019 * Covariates
Sex (Feam le= 1, M ale= 0) -.005 -.008 -.006 -.005 -.004
Age (aged 65 and over) .001 .001 .001 .001 .001 Sex of fam ily caregivers -.001 -.007 -.003 -.002 .001
Age of fam ily caregivers (Feam le) .000 .000 .000 .000 .000 Level-2 Country and region level
G D P per person in 2015 .000 ** .000 **
has Public LTC .079 Level 1 *2 : Cross-level interations P erceived care services*G D P .000 P erceived care services*has Public LTC -.021 ** R andom Effect Param eters (Country and Rejon: Japan, Korea, China, and Taiwan)
Level-1 : regidual .115 ** .119 ** .119 ** .119 ** .118 ** .118 **
Level-2 : intercep .004 .004 .001 .002 .000 .295 .002
M odel fit statistics
(-2) Res log likelihood 1746.06 1632.611 1622.917 1630.788 1608.061 1617.299
AIC 1762.06 1656.611 1648.917 1656.788 1638.061 1647.299
B IC 1808.82 1725.420 1723.460 1731.331 1724.072 1724.072 N 2552 2285 2285 2285 2285 1733 N ote **p< .01 *p< .05
40 Kim / Factors Predictive of Preferred Place... At the country and region level, GDP per person in 2015 and public LTC system are included in the model one at a time (Table 4, Models 3-5). Family caregivers who live in countries or regions of high GDP were statistically significantly associated with strong preference place of NHs for end-of-care and death for frail elderly persons (p<.01) (Model 3 and Model 5). However, only the public LTC system was statistically not significantly associated with preferred place of NHs (Model 4). Additionally, the study tested interaction effects between statistically significant individual- level perceived care service by professional care workers and nurses and country and region- level LTC system. These analyses yielded one statistically negatively significant cross-level interaction between receiving care services from professional care workers and nurses and having a public LTC system (p<.01) (Model 5). This means that family caregivers who received many different types of care support from professional care workers and nurses and who live in counties and region with public LTC system were less likely toprefer NHs for end-of-care and death for their relatives. Discussion This article explored the individual care needs and economic situations, countries and regional GDP and LTC system that influence caregivers’ preferred place of NHs for end-of-care and death for frail elderly persons in 3 countries and 1 region. The study found partial support for the first hypothesis that family caregivers of the frail elderly with an advanced dementia risk were more likely to preferend-of-care and death for the frail elderly persons in a NH (H1);however, no support was found for the hypothesis thatfamily caregivers of the frail elderly with higher ADL impairment were more likely to preferend-of-care and death for frail elderly persons in a NH.Support for the second hypothesis of the study that family caregivers who received many different types of care service were more likely to preferend-of-care and death in a NH for frail elderly (H2); In the third hypothesis of the study, family caregivers with higher socio-economic status of frail elderly were more likely to prefer end-of-care and death in a NH (H3), a finding that supports reverse causation.We could find partialsupport for the fourthhypothesis of the study that familycaregivers who live in countries and regions with the highest GDP per capita were more likely to prefer end-of-care and death in a NH as the actual place for the frail elderly, but we could find no support for the hypothesis of the study that family caregivers are more likely to prefer end- of-care and death in a NH(H4). Subsequently, the study discusses these results and reviews limitations. As expected, the study indicatespartial support for the first hypothesis that family caregivers of the frail elderly with dementia risk were more likely to prefer end-of-care and death for the frail elderly persons in a NH (H1). To our knowledge, no research has shownassociation between caregiver rated dementia symptoms and preference of place of NHs for end-of-care and death for frail elderly. However, some previous studieshave focused onthe association of dementia and ADL levels of the frail elderly and care burden of family caregivers; family caregivers’ burdenswere higher in dementia than in other diseases (Mougias et al. 2015)and lower in ADLs of frail elderly persons (Kim, 2001). One possibility for this is that family caregivers of the frail elderly with high behavioral symptoms of dementia can’t keep up their good health. Further, family caregivers who are already employedwill be limited as to how theygive care and support for the frail elderly with advanced dementia symptoms.Thus, family caregiverswho care for frail elderly with advanced
41 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 dementiawill preferred place of NHs for end-of-care and death for frail elderly persons.However, no support was found for the study that family caregivers of the frail elderly with higher ADL impairment were more likely to preferend-of-care and death for frail elderly persons in a NH.Prospective study of family caregivers suggests that the degree of dementiain frail elderly has asignificant interaction with ADL functioning of frail elderly (Kim, 2001);thus, the ADL functioning of frail elderly persons was not significantly related with preferred place of NHs for end-of-care and death for frail elderly persons. Family caregivers who received many different types of care services by care workers or nurses were more likely to prefer NHs for end-of-care and death for the frail elderly by family caregivers.However, family caregivers who received many different types of care support from care workers and nurses and who lived in countries and regions with public LTC systems were less likely to prefer NHs for end-of-care and death.One possibility is that family caregivers who received many different types of service may have high levels of psychological distress, anxiety, care burden, and depression. Because caregivers often experience psychological, behavioral, and physiological effects, thesecan contribute to impaired immune system function and coronary heart disease, and early death (Lee et al, 2003; Schulz and Beach, 1999).However, family caregivers are lesslikely to prefer NHs when they received many different types of care services from care workers and nurses live in countries and regions with an LTC system. Perhaps LTC services are provided quickly and many different types of services at homes.These observations may reflect the family caregivers who live with an LTC system prefer and refers to shifting the balance of LTC utilization and expenditures for long-term supports towards less institutional service and more community services. Family caregivers who lived with the frail elderly andhad strong socio-economic backgrounds and who lived in countries and regions, andthe highest GDPs were significantly associated with NHs as a preferred place for end-of-care and death.Frail elderly persons with accumulating health problems may be concerned with their families’ capacity to provide support and the burden they place on their family. Financialconcerns may lead individuals to prefer external support sources that allow both frail elderly persons and their children to maintain independencyduring long-term care (Sperber et al, 2014; Christine et al. 2015).Financially deprived frail elderly persons have more palliative care needs or more comorbidity, and they need more health care services; thus, family caregivers will beto prefer death inNHs forend-of-care and death.Further, family caregivers living in countries and regions with the highest GDPs are consistent with previous literature that notes a correlation between existing state police and individuals’ police preference (bettio & Plantege, 2004; Mair et al. 2016). Specifically, GDPs per capita is associated with higher preference place of NHs for dyingin East Asia. Living in countries and regions with a higher GDPs per capitamay shape individual opinion favorably toward countries and regions in East Asia. Considering Japanese historical and current investment in developing welfare states, both processes may be at work jointly and influence East Asia. However, despite the consistent association between care need and support and economic background, some factors revealed no significant associations in the study results. For example,age and sexof frail elderly and family caregivers, the length of time for care and support, and ADLs of the frail elderly had no association with preferred place for end-of-care and death.The reason for
42 Kim / Factors Predictive of Preferred Place... these are unclear, and further research is required to confirm these findings and investigate the reasons behind them. Conclusion Considering changing family support option, public attitudes toward the welfare state,GDPs growth rate, LTC system infrastructures, and importance of preference placefor dying should may help to develop an effective end-of-life carein East Asia. The findings from this study have implications on the dementia risk, received care support from care works, economic situation, and GDPs per capitawere stronger predictors of preferred place of NHs for end-of-care and death. It is necessary to consider individual preferences and public health strategies in order to enable elderly people to receive suitable and comfortable end-of-care and death in their preferred location. Limitations and Suggestions for Further Research Although this article examines a focused set of preferencesfor end-of-care and death predictors and covariates, the study has several limitations. First, the number of countries and regions was relatively small; future studies should explore these issues within and beyond East Asia. Second, this study only examined cross-sectional research of preferred placesfor end-of- care and death.Future studies should explore place of death within and beyond East Asia. Third, because of the nature of investigating only family caregivers, the study is limited in independent and dependent factors such as children, relatives, and roommates who might influence the preference for end-of-care and death locations. Future study would be beneficial to reveal more specific factors and main caregivers who live separately from frail elderlybased in countries and regions of support References Akiyama, A. Numata, K. & Mikami, H. (2007). “Factors influencing the death of the elderly at home in an institution specializing home medical care -Analysis of survey of the bereaved family”. Japan Ronen Igakku Zassi, 44(6): 740-746. All, M. Capel, M. Jones, G. and Gazl, T. (2015). “The importance of identifying preferred place of death”. BMJ Support Palliat Care doi:10.1136/bmjspcare-2015-000878.Care work foundation, (https:// careerlove.jp/careworker-turnoverrate-1063, 2015.12.28). Kim, J.N. (2015). “A positive and negative appraisal of the care giving of family caregivers for frail elderly living at home in Japan and South Korea”. Odisha Journal of Social Science, 2(1), 4-16. Kim, J.N. (2016). “The measuring of quality of care for frail persons in nursing homes in Japan”. Odisha Journal of Social Science, 2(1), 4-15. Kim JN. (2001). “Family caregivers burden when caring for frail elderly at homes in Soul City”. Japanese Journal of Gerontology, (23)1, 50-60. Coupland, V.H. Madden, P. Jack, R.H. et. al. (2011). “Does place of death from cancer vary between ethnic groups in South East England?”. Palliate Med 2011; 25: 314–322. Fukui, S.; Yoshiuchi, K.; Fujita, J. et. al. (2011). “Japanese people’s preference for place of end-of-life care and death: a population-based nationwide survey”. J Pain Symptom Manage. 43(6): 882-892. Higginson, I.J.; Jarman, B.; Astin, P.; Colan S. (1999). “Do social factors affect where patients die: an analysis of 10 years of cancer deaths in England”. Journal of Public Health Medicine, 21(2): 22-28. Higginson, I.J.1.; Sarmento, V.P.; Calanzani, N.; et. al. (2013). “Dying at home—is it better: a narrative appraisal of the state of the science”. Palliate Med. 27(10):918-924. 43 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Lee, S.; Colditz, G.A.; Berkman, L.F.; Kawachi, I. (2003). “Care giving and risk of coronary heart disease in U.S. women: A prospective study”. Am. J. Prev. Med. 24(2):113–119. Mair ,C.H.; Quiñones, A.R.; and Pasha, M.A. (2015). “Care preferences among middle-aged and older adults with chronic disease in Europe: individual health care needs and national health care infrastructure”. The gerontological, 56(4): 687-701. Ministry of Internal Affairs and Communications. (2014). Census of the all Japan’s population. Ministry of health, Labor and Welfare. (2015). Research study on evaluation of quality to LTC services. (http://www.mhlw.go.jp/file/05-Shingikai-Sanjikanshitsu_Shakaihoshoutantou.pdf, 2016.11.21) Mougias, A.A.; Politis, A.; Mougias, M.A. et. al. (2015). “The burden of caring for patients with dementia and its predictors”. Psychiatric. 26(1):28-37. Munday, D.; Shipman, C. (2009). “Introduction: concepts, scope and models of continuity in palliative care”. In: Munday D, Shipman C, editors. Continuity in palliative care: key issues and perspectives. London: RCGP. Munday, D. Petriva, M. & Dale, J. (2009). “Exploring preferences for place of death with terminally ill patients: qualitative study of experiences of general practitioners and community nurses in England. BMJ, 1-9. Munday, D. & Dale, J. (2007). “Palliative care in the community”. BMJ, 334:809-10. Ohamachi, I.; Arima, K.; Abe, K. et. al. (2015). “Factors Influencing the Preferred Place of Death in Community-dwelling Elderly People in Japan”. International journal of Gerontology. 9(1):24-28. Percival, J. & Johnson, M. (2013). “End-of-life care in nursing and care homes”. Nursing Times.109(1-2): 20-22. Raudenbush, S.W. & Bryk, A.S. (2002). “Hierarchical linear models: Applications and data analysis methods (2nd ed.). Newbury Park: Sage. Sasaki, M.; Arai, A.; & Arai, (2008). “Preferred and actual place of death among community”. National Institute for longevity Sciences. 45(6): 622-626. Schulz, R.; Beach, S.R. (1999). “Care giving as a risk factor for mortality - The caregiver health effects study”. Jama-J Am Med Assoc. 282(23):2215–2219. Sperber, N.R.; Voils, C.I.; Coe, N.B. (2014). “How can adult children influence parents’ long-term care insurance purchase decisions?” The Gerontologist 2014. Sperber, H.; Beem, A.; Shannon, S.; et. al. (2014). “Mi RNA sensitivity to Drosha levels correlates with pre-miRNA secondary structure”. RNA 20, 621-631.
44 BEHAVIOURAL ASSESSMENT AND SKILL TRAINING OF TWO CHILDREN WITH INTELLECTUAL DISABILITY Binaya Bhusan Mohapatra* Abstract All Mentally Handicapped Children show deficits in some of the skill behaviours. Skill deficits can be measured by Behavioural Scales, such as, Madras Developmental Programming System (MDPS). A skill can be taught to a Mentally Handicapped Child through the application of learning principles. Two Moderate level Mentally Handicapped Children were given training in Colour Concept, Vegetable Cutting, Identification and Naming of Coins, Counting number of Objects, Writing his Name, and Identification of Big and Small. Keyword : Intecentual Disability, BASIC-MR, MDPS. All mentally handicapped children show deficits in some skill behaviours. This means that they perform poorly on certain tasks which normal children of their own age can do easily. What a given mentally handicapped child can do or cannot do, depends on various factors such as severity of MR, opportunity provided for training, associated conditions etc. the various skill behaviours can be broadly classified into the following categories of domains:-Motor activities,Activities of daily living,Language,Reading and Writing,Number and Time,Domestic and Social,Prevocational and Money.A skill can be taught to a mentally retarded child through the application of learning principles, such as, arranging consequences that increase behaviour, arranging consequences that decrease behaviour and stimulus control and shaping through differential reinforcement. Reinforcers could be categorized into two types, namely, Primary reinforcers, and Secondary reinforcers. Primary reinforcers may be edible reinforcers, e.g. Foods and liquids or sensory reinforcers, e.g. Exposure to controlled visual, auditory, tactile, olfactory, or kinaesthetic experiences. Secondary reinforcers are: (a) Tangible (Material) reinforcers e.g. Certificates, badges, stickers, balloons etc., (b) Privilege reinforcers e.g. class monitor, team captain, excuse from home work etc., (c) Activity reinforcers e.g. Play activities, special projects, access to media, etc. (d) Generalized reinforcers e.g. Tokens, points, credits, (e) Social reinforcers e.g. Expressions, proximity, contact, words and phrases, feedback, seating arrangements etc. A skill training programme for a mentally retarded child begins with behavioural assessment. Behavioural assessment can be done by administering one of the standardized behavioural scales. Two such scales, namely, Madras Developmental Programming System (MDPS), and Behavioural Assessment Scale for Indian Children (BASIC-MR), are developed in India and widely used. In the present study, MDPS has been used to assess the current level of skill development.
* Asst. Professor in Special Education,Jewels International Chetana College of Special Education, Bhubaneswar. Email- [email protected] 45 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
The current level of skill development shows the achievements and deficits of a Mentally Retarded child in various skill areas before intervention. The special teacher will prioritize the skills to be taught on the basis of the needs of a child, and select a goal which is required to be achieved immediately, e.g. If a child has deficits in the self-help skill area, then, that will be addressed first, before taking up functional academics or socialization skills. After selection of a goal (skill to be taught) a teacher is required to determine exactly what steps, links, or components must be included in the behavioural chain for teaching the skill. Breaking complex behaviour into its component parts is called task analysis. Task analysis requires considerable practice but can be applied to behaviours ranging from eating with a spoon to writing a term paper. The components of a task analysis form what behaviourist call a behavioural chain. The instructional procedure of reinforcing individual responses for occurring in sequence to form a complex behaviour is called chaining. The correct steps in a behavioural chain can be taught through the application of the discrimination. The process of teaching involves prompts, modelling, physical guidance, fading, decreasing assistance, graduated guidance, and time delay. Many studies have been conducted to demonstrate skill training in Mentally Retarded Persons, Didden, Prinsen, and Sigafoos (2000) studied the blocking effect of pictorial prompts on sight word reading of children with moderate mental retardation. The results showed that acquisition was achieved fastest during the word alone condition. Stith and Fishbein (1996) studied the basic money counting skills of children with mental retardation. The results revealed that as the complexity of thread counting task increased the number of errors, made by the children with mental retardation also increased. McEvoy and McConkey (1991) studied the performance of children with moderate mental handicap on simple counting tasks. Findings indicate deficiencies in basic counting competencies of these children. Singleton (1999) studied the prompting procedures in teaching grocery words to indicate that the antecedent prompt and test procedure was more efficient on measures of acquisition, whereas, simultaneous prompting was more efficient on measures of maintenance and generalization. Trace, Curo, and Criswell (1977) designed a programme to teach coin equivalence performance and maintained their skill on one week, and one month follow up tests. The above noted studies are examples of skill training in mentally retarded. The skill areas studied are- reading skill, counting skill, and monetary skill. The present study intends to assess two mentally retarded children by the Madras Developmental Programming System (MDPS), and to teach a number of functional skills. Methods Subjects Two mentally retarded children were selected from the Chetana Institute for the Mentally Handicapped for the study. The details of the subjects are as follows :-
46 Mohapatra / Behavioural Assessment and Skill Training... 1. Name- Miss Geetanjali Patra Age- 13 years Sex- Female Condition- Moderately Mentally Retarded. 2. Name- Mr. Chitaranjan Mohapatra Age- 10 years Sex- Male Condition- Moderately Mentally Retarded. Both the subjects cooperated in the skill training programme. Test Material Used The Madras Developmental Programming System (MDPS) developed by Prof. P. Jeyachandran and Prof. V. Vimla, (1975), published by Vijay Human Services, Chennai, has been used to assess the level of skill development of the subjects. The basic features of the scales are as follows:- (i) It contains 360 observable adaptive behaviour skills grouped under 18 domains. (ii) The 18 domains are arranged in developmental sequence. (iii) The 360 items are positive statements, which are measurable. (iv) All the items focus on functional behaviour, which normally occur in the daily life of an individual. (v) Item number 1 to 20 in each domain always moves from dependence to independence. (vi) The scale is so constructed that the items move from simple to complex. The names of the domains are : (1) Gross motor activities, (2) Fine motor activities, (3) Meal time activities, (4) Dressing, (5) Grooming, (6) Toileting, (7) Receptive language, (8) Expressive language, (9) Social Interaction, (10) Reading, (11) Writing, (12) Number, (13) Time, (14) Money, (15) Domestic Activities, (16) Community Orientation, (17) Recreation, and Leisure Time Activities, and (18) Vocational Activities. Teaching Materials for Subject No. 1 1. Teaching Material for Colour Concept-Red, Green, and Yellow Cards and Blocks. 2. Teaching Materials for Vegetable Cutting- Knife and different types of vegetables. 3. Teaching Materials for Identification and naming of coins- 5 drawing sheets pasted with 1 rupee, 50 paise, 25 paise, and 10 paise coins and 5 sets of loose coins of the said denominations. Teaching Material for Subject No.2 1. Teaching materials for the skill counting number of objects – 10 numbers of white Wooden Blocks-5 cmX5 cm size. 2. Teaching materials for writing- Pencil and Exercise book. 3. Teaching materials for Identification of Big and Small- Big Pencil-Small Pencil, Big Bottle- Small Bottle, Big Glass-Small Glass, Big Ball-Small Ball, Big Tray- Small Tray.
47 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Procedure Behavioural Assessment The MDPS Behavioural Scale was used to assess both the subjects to know the level of development in all the 18 skill areas. The assessment included direct observation of the children in their natural setting, interview with the caretakers, teachers, and study of the case history of both the subjects. Assessment was done over a period of 10 days. Selection of Skills for Training and Assessment of Current Level On the basis of the Behavioural Assessment the following skills were selected for training:- Subject 1- Miss. Geetanjali Patra Skill selected for training- (1) Identification and Naming of Colour (2) Cutting of Vegetables, and (3) Identification of big and small. Subject 2- Mr. Chitaranjan Mohapatra Skills selected for training- (1) Counting number of objects, (2) Writing his name, and (3) Identification of big and small. Subject 1- Ms. Geetanjali Patra 1. Identification of Colour- In identification of colour, the subject was able to match the colour, but failed to identify and name a colour. 2. Cutting of vegetables- In cutting of vegetables, she did not know how to hold a knife, but was able to bring vegetables when directed. 3. Identification of coins – In identification of coins, she was able to match the coins of 1 Rupee, 50 paise, 25 paise, and 10 paise but failed to identify and name the said coins. Subject 2- Sri Chitaranjan Mohapatra 1. Counting number of objects- In counting number of objects, the subject was able to count only two numbers of objects. 2. Writing his name- In writing of his name, the subject was able to trace the letters. 3. Identification of big and small- In identification of big and small, the subject was unable to tell which one was bigger of the two objects. Skill Training The subject No.1 was given training with an objective to (1) Identify and Name Red, Green, and Yellow colours, (2) Cut Vegetables and (3) Identify and Name coins of 1 Rupee, 50 paisa, 25 paisa and 10 paisa denominations.
48 Mohapatra / Behavioural Assessment and Skill Training... The subject was taught the three skills in three sessions every day between 10 A.M. to 1.00 P.M. There was a gap of 30 minutes between two sessions. The first session was devoted to teach ‘Concept of Colours’ to the subject. Red, green, and yellow colour cards and Blocks were brought to the place of training. The trainer placed a Red colour card in front of the subject and said “this is Red colour” and then asked the subject to repeat the same. Every day the subject was given 10 trials like this. The training continued for30 days. In the process the subject was taught to identify and name Red, Green and Yellow colours. The second session was devoted to teach the skill ‘Cutting of Vegetables’. The trainer brought a knife and vegetables to the place of training. The trainer sat on the right side of the subject and showed him how to hold the knife in an appropriate manner. Then she demonstrated how to place the knife on the vegetable and cut it to pieces. Then she helped the subject to hold the knife and cut the vegetables properly. Every day the subject was given 10 trials like this. The training continued for 30 days. In the process the subject learned to cut different types of vegetables. The third session was devoted to ‘Identification and Naming of Coins’. The trainer brought five drawing sheets pasted with 1 Rupee, 50 paisa, 25 paisa, 10 paisa and 5 sets of loose coins of the said denominations to the place of training. The trainer placed one drawing sheet with the coins in front of the subject and asked him to identify and name each coin. When he failed to identify and name each coin, the trainer verbally and physically prompted the name of the coin. Every day the subject was given 10 trails like this. The training continued for 30 days. In the process the child learned the coin identification and naming skill, but could not reach the level of independence. In the process of training, the subjects proceeded from a condition of dependence to a condition of independence in respect of the skills taught except the identification and naming of coins. The process of training and intervention consisted of physical prompting, physical and verbal prompting and verbal prompting only. Finally, the subjects performed the skills independently without any intervention from the trainer. During the training, the subjects were given verbal and/ or material reward for each successful performance. The material reward was chocolates and the verbal reward was words of praise. The performance of the subjects was scored in the following method: dependent 0, Physical prompting – 1, Physical prompt & Verbal Prompting -2, Verbal prompting-3, Independent -4. Similarly, all the three selected skills, i.e., (1)Counting number of objects (2) Writing his name and (3) Identification of big and small, were taught to the subject No.2. The skills were taught for 10 trials a day, for 30 days. The methodology followed was the same as for subject No.1. The teaching materials described in the ‘Test Material’ section were used for the skill training. In the process, the subject learned all the three selected skills. In respect of the skill “writing his name”, the subject could not achieve independence.
49 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Table-1 Mean Achievement Scores of the Subject No.1, Ms. Geetanjali Patra. Sl No. Skills Day 5 Day 10 Day 15 Day 20 Day 25 Day 30 01. Identification of Colours. 1 2 2 3 3 4 02. Cutting Vegetables. 1 2 3 3 3 4 03. Identification of Coins. 1 2 2 2 3 3
Table-2 Mean Achievement Scores of the Subject No. , Mr. Chitaranjan Mohapatra. Sl.No. Skills Day 5 Day 10 Day 15 Day 20 Day 25 Day 30 01. Counting of Objectws. 1 1 2 3 3 4 02. Writing his Name 1 1 2 2 3 3 03. Identification of Big & Small 1 2 3 3 4 4 Result and Discussion The objective of the present study was to conduct behavioural assessment of two mentally retarded children by using the MDPS, and teach three selected skills to each of them. It was expected that the children would learn the selected skills within the stipulated period of 30 days. MDPS assessment revealed that mostly, both the children performed better in self-help skills, and poor in Language skills, Socialisation skills, Academic skills and Vocational skills. Achievement of less than 10 items in each domain was considered poor performance, whereas achievement of more than 10 items was considered as good performance. MDPS assessment revealed that the subject No.1, Mr. Chitaranjan Mohapatra, had good performance in Gross motor activities, Fine motor activities, Meal time activities, Grooming and Toileting. The mean achievement score was 13.6 out of 20. His performance was poor in Dressing, Receptive Language, Expressive Language, Social Interaction, Reading, Writing, Number, Time, Money, Domestic Activities, Community Orientation, Recreation and Leisure Time Activities, and Vocational Activities. The mean achievement score was 5.1 out of 20. MDPS assessment of subject No.2, Ms. GeetanjaliPatra, revealed that she was good in Gross motor activities, Fine motor activities, Meal time activities, Grooming, Toileting and Receptive Language. The mean achievement score was 14.8 out of 20. Her performance was poor in Dressing, Expressive Language, Social Interaction, Reading, Writing, Number, Time, Money, domestic Activities, Community Orientation, Recreation and Leisure Time activities and Vocational activities. The mean achievement score was 4.2 out of 20. It may be concluded that both the subjects require planning and implementation of Individual Educational Programme (IEP), for possible improvement in the poorly performed skills. The second objective of the present study was to provide training to both the subjects in selected skilsl through the established methods of Individual Educational Programme (IEP). The subjects were found to be in a preliminary stage of development, with regard to the selected skills. 50 Mohapatra / Behavioural Assessment and Skill Training... The results indicated that the subject 1 achieved independence in respect of ‘Identification of Colours’, and ‘Cutting Vegetables’. However, the subject could not achieve independence in respect of the skill ‘Identification of Coins’. Similarly, the subject No.2 achieved independence in respect of counting number of objects and Identification of big and small. However, the subject could not achieve independence in respect of writing his name. The results are presented in Table-1 and Table-2. For convenience, all the data collected over a period of five days is clustered into one unit. Scoring System: Dependence-0, Physical Prompt-1, Physical and Verbal Prompt-2, Verbal Prmpt-3, Indpendence-4. It may be stated that the difficulty level of the skill determines whether a subject will achieve independence within a stipulated period of time. In the present study, the subject No.1 could not achieve independence in ‘identification of coins’ and the subject No. 2 could not achieve independence in ‘writing his name’. It may be concluded that due to higher difficultly level of the skills, the subjects could not achieve independence within the stipulated training period of 30 days. It is suggested that a further period of training may improve the level of skill development of the subjects. Further, it may be stated that it may not be possible to teach some of the difficult skills to a mentally retarded child, in spite of the best trials. After trying for a reasonable period of time, the trainer should discontinue training of a difficult skill, otherwise, too much of pressure on a week brain may lead to behavioural problems. The trainer should continue to assess and reassess the achievements of a mentally retarded child, and take appropriate decisions keeping in mind the wellbeing of the child. References Alberto, P.A. & Troutman, A.C. (1995). “Applied Behaviour Analysis”. Prentice-Hall Inc., A Simon and Schuster Company, Englewood Cliffs, New Jersey, 07632. Didden, R. Prinsen, H. & Sigafoos, J. (2000). “The Blocking effect of Pictorial Prompts on Sight Word Reading”. Journal of Applied Behaviour Analysis, 33(3), 317-320. Jeyachandran, P. & Vimala, V. (1975). “Madras Developmental Programming System”. Vijay Human Services, Lakshmipuram Street, Roypettah, Chennai, India. McEvoy, J. & McConkey, R. (1991). “The Performance of Children with a Moderate Mental Handicap on Simple Counting Tasks”. Journal of Mental Deficiency Research, 35(5), 446-458. Singleton, D.K. (1999). A comparison of Antecedent Prompt and Test and Simultaneous Prompting Procedures in Teaching Grocery Words to Adolescents with M.R. Education and Training in M.R. and Developmental Disabilities, 34(2), 182-199. Stith L.E. & Fishbein H.D. (1996). Basic Money counting skills of children with Mental Retardation. Research in Developmental Disabilities, 17(3), 185-201. Trace, M.W, Curo A.J. & Criswell, J.l. (1997). “Teaching coin equivalence to the mentally Retarded”. Journal of Applied Behaviour Analysis 10, 85-92. 51 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 PROBLEMS OF BEHAVIOUR MANAGEMENT OF CHILDREN WITH INTELLECTUAL DISABILITY- A STUDENT OF CHETANA INSTITUTE FOR THE MENTALLY HANDICAPPED, BHUBANESWAR Bichitrananda Swain* Abstract The present investigation was designed to see the effectiveness of behaviour modification technique on the management of “Tongue biting” behaviour of a Mentally Retarded child. The subject for the study was taken from Chetana Institute for the Mentally Handicapped, Bhubaneswar. The analysis of result suggests that, Rescheduling of activities and Differential Reinforcement of Alternative Behaviour was effective in reducing the tongue biting behaviour of the subject. Keywords : Behavioural Management, Mantalty & andicapped, SIB, IABS, DNRO. Many times children with Intellectual Disability show behaviour that are considered as problematic, because of the harm or inconvenience, they cause others or to the child himself.Generally behaviours are considered problematic if they meet at least one of the criteria (i) when the behaviours are damaging to self or others,(ii)when the behaviours are inappropriate for the age group,(iii)when the behaviour interferes in learning,(iv)when behaviours are socially deviant,(v)if the behaviour occurs more frequently or for long periods of time or vary severely in nature. There are various problem behaviours which can be classified into following categories: (1) violent and Destructive behaviours (2) Miss-behaviours with others (3) Temper tantrums (4) Self- injurious behaviours (5) Repetitive behaviours (6) Odd behaviours (7) Rebellious behaviours (8) Anti-social behaviours (9) Fear. There are many ways of recording the problem behaviours, (i) Event recording (ii) Duration Recording (iii) Internal Recording (iv) Time Sampling.There are different factors which contribute to cause problem behaviours. Those are (1)Attention seeking factor (2)Self-stimulation(3)Skill deficit (4)Escape (5) Tangible factor.Technique to reduce the problem behaviour are broadly divided into two categories viz. (1) Non –punishment technique (2) Direct punishment technique.Under Non-punishment technique :(1)Differential reinforcement of incompatible behaviours (DRI) (2) Differential reinforcement of low rate behaviour (DRL). Under Direct punishment technique (1) Restructuring the environment (2)Extinction (3) Time out (4) Response prevention (5) physical restraint (6) Response cost (7) Restitution/restoration (8) Over correction (9) Aversive therapy (10) Graduated exposure for fears. Randoll, Steven, Treadway and Marshall (1995) investigated opiate antagonists have shown promise for treating a subset of self-injurious patients. Use of naltrexone with 3 mentally retarded adults who had long histories of self-injurious behaviour and unsuccessfulbehavioural and drug treatments decreased the self-injurious behaviour, Improvement was sustained beyond the time usually seen in placebo response.Edward and Moses (1989) evaluated the use of brief arm restraint plus differential reinforcement of alternative
*Asst. Professor in Psychology,Jewels International Chetana College of Special Education, Bhubaneswar, e mail- [email protected] 52 Swain / Problems of Behaviour Management... behaviour to treat the self-injurious behaviour (SIB) of one 31 year old female and one 19 year old male nursing home resident with multiple handicaps and profound mental retardation.The 1st subjects responding appeared to be associated with the presence of the treatment programme as supported by the multiple baseline across inappropriate behaviours (IABS) and by the unintended withdrawal and subsequent reinstatement of the treatment. The 2ndsubject’s ABS and appropriate behaviours were positively influenced by the introduced treatment procedures. Results indicate that treatment effectively reduced subjects SIBS and IABS, replicating an earlier study (Azrin et al. 1982) that used similar procedures to reduce self- injurious behaviour. Han-Leong and Brian (1994) conducted a study on behavioural persistence and variability during extinction of self-injury maintained by escape. The self-injurious escape behaviour of a 40 years old male with profound mental retardation was treated with extinction. Results of a reversal design show substantial bursts of responding when extinction was introduced and reintroduced: self-injury remained at a variable and elevated rate for some time before stable, low rates were observed. Data on aggression, behaviour during both baseline and treatment, showed a pattern similar to that seen for self-injury during the extinction conditions. Roberts, Mace and Daggett (1995) compared the effectiveness of differential negative reinforcement of other behaviour (DNRO) and differential reinforcement of alternative behaviour (DNRA) for reducing self-injurious tantrums maintained by escape from demands in a 4 year old girl with severe retardation. Both DNRA and DNRO reduced self-injuring and increased independent performance of 2 tasks (tooth brushing and bathing); however, improvement on both measuring was greater with the DNRA intervention. Rationale Managing problem behaviours is necessary because, problem behaviours reduce the social acceptability of the child, cause harm to the child and it may harm others too. It may interfere in the learning process at school or home and may interfere in the learning process of other children at school or home. It may be socially unacceptable and in appropriate for the child’s age and it may interfere in the performance of certain other behaviour already learned by the child. Present study was designed to manage the self- injurious behaviour “Tongue biting “ of BrundabanMaharana through application of Behaviour Modification Techniques such as : (i) Rescheduling of activities ,(ii)Differential Reinforcement of Alternative Behaviour. Method Subject : Brundaban ,11 year old boy from rural background was admitted in Chetana on 14th July ,1998 ,under residential facilities. The developmental history revealed that, he was a premature baby. His birth cry was delayed .The child suffered from delayed development of mile stone. His communication and social skills are markedly deficient .He needs assistance in activities of daily living. His IQ is 26 according to Vineland Social Maturity Scale. For the purpose of educational intervention, he is placed under pre-primary group at Chetana institute. Experience: the ABAB design was followed for the study. The ABAB sequence means intervention Phase-1, withdrawal Phase-1, intervention Phase-2, withdrawal Phase-2.
53 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 Tools Used: 1. Personal date sheet 2. Behavioural Assessment Scale for Indian children with Mental Retardation (BASIC-MR) Part-B. The scale has 75 items which are grouped under 10 categories of problem behaviour. 3. Madras Developmental Programming System (MDPS) Procedure The investigation and intervention were conducted both in classroom settings as well as Hostel. The special educators and caretakers of the School were involved in the intervention process. Assessment of Problem Behaviour: The child was assessed by the Behavioural Scale BASIC-MR, Part-B, information from parents, class teachers and attendants. The assessment revealed the following behaviour: 1. Self-injurious behaviour- he bites his tongue repeatedly. 2. Violent and destructive behaviour-pushes others. 3. Repetitive behaviour- he rocks his body frequently. 4. Misbehaviour with others-he pulls objects from others. 5. Odd behaviour- he kisses others unnecessarily. 6. Hyperactive behaviour- he does not pay attention to what is told. The observation of Class teacher, attendants, parents and investigators suggested that the most frequent problem behaviour was tongue biting. This behaviour causes injury to the child’s body. So it was targeted for management. Functional Analysis of Problem Behaviours Two weeks observation in classroom, hostel and other setting suggested the following antecedent and consequence of problem behaviour. The occurrence of the problem behaviour is higher under the following conditions: 1. In the classroom when some question is asked to him, 2. When the teacher is busy with other children. 3. When he is sitting alone. 4. When his classmates are playing. The frequencies are less under following conditions: 1. Whenever he is playing with toys. 2. Whenever he is listening music. 3. Whenever he eats mixture or chocolate.
54 Swain / Problems of Behaviour Management... Table-1 Baseline Phase-1 Recordings of the Problem behaviour ‘Tongue Biting’. Session Date Time Duration of Frequency Rate per observation session minute 1 10/07/16 11.00-11.30 30 mts. 22 0.73 2 11/07/16 11.00-11.30 30 mts. 20 0.66 3 12/07/16 11.00-11.30 30 mts. 21 0.7 4 13/07/16 11.00-11.30 30 mts. 18 0.6 5 14/07/16 11.00-11.30 30 mts. 23 0.76 Average rate of frequency per minute = 0.69 Table-2 Intervention Phase-1 Recordings of the problem behaviour ‘Tongue Biting’ Session Date Time Duration of Frequency Rate per observation session minute 6 15/07/16 11.00-11.30 30 mts. 19 0.63 7 16/07/16 11.00-11.30 30 mts. 17 0.56 8 17/07/16 11.00-11.30 30 mts. 10 0.33 9 18/07/16 11.00-11.30 30 mts. 7 0.23 10 19/07/16 11.00-11.30 30 mts. 3 0.1 Average rate of frequency per minute = 0.37 Design and sequence An ABAB design was applied in the following sequence: Baseline Phase-1 - 5 sessions Intervention Phase-1 -5 sessions Baseline Phase-2 -5 sessions Intervention Phase -2 -10 sessions Follow up Phase -5 sessions Baseline Phase-1 The baseline phase-1 was gathered for problem behaviour tongue biting. The duration for one observation session was kept 30 minutes. Only one observation session was conducted in a day. During baseline observation, the investigator did not interact with the subject. Numbers of frequencies of tongue biting problem behaviour were recorded. The recordings are given in Table- 1‘ and shown in the Figure-1 (A). The rate has been calculated as per the following formula. Average rate per minute has been calculated as per the following formula; Intervention was done in classroom setting as well as in the hostel. During the intervention following techniques and tasks were used.
55 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Table 3: Baseline Phase-2 Recordings of the problem Behaviour ‘Tongue Biting’ Session Date Time Duration of Frequency Rate per observation session minute 11 20/07/16 11.00-11.30 30 mts. 5 0.10 12 21/07/16 11.00-11.30 30 mts. 3 0.1 13 22/07/16 11.00-11.30 30 mts. 4 0.13 14 23/07/16 11.00-11.30 30 mts. 6 0.2 15 24/07/16 11.00-11.30 30 mts. 8 0.26 Average rate of frequency per minute = 0.17 Table 4: InterventionPhase-2 Recordings of the problem Behaviour ‘Tongue Biting’ Session Date Time Duration of Frequency Rate per observation session minute 16 25/07/16 11.00-11.30 30 mts. 5 0.16 17 26/07/16 11.00-11.30 30 mts. 4 0.13 18 27/07/16 11.00-11.30 30 mts. 4 0.13 19 28/07/16 11.00-11.30 30 mts. 3 0.1 20 29/07/16 11.00-11.30 30 mts. 2 0.06 21 30/07/16 11.00-11.30 30 mts. 1 0.06 22 31/07/16 11.00-11.30 30 mts. 1 0.06 23 01/08/16 11.00-11.30 30 mts. 0 0 24 02/08/16 11.00-11.30 30 mts. 0 0 25 03/08/16 11.00-11.30 30 mts. 0 0 Average rate of frequency per minute = 0.07 Intervention Phase-1 The intervention phase-1 was initiated on 6th session. The intervention was implemented in the following manner: 1. Rescheduling of activities The following activities were given: i) He was given different types of toys of play.
Table 5: Follow up Recordings of the problem Behaviour ‘Tongue Biting’
Session Date Time Duration of Frequency Rate per observation session minute 26 04/09/16 11.00-11.30 30 mts. 8 0.26 27 06/09/16 11.00-11.30 30 mts. 6 0.2 28 08/09/16 11.00-11.30 30 mts. 7 0.23 29 10/09/16 11.00-11.30 30 mts. 9 0.3 30 19/09/16 11.00-11.30 30 mts. 8 0.26 Average rate of frequency per minute = 0.25 56 Swain / Problems of Behaviour Management... ii) He was given chance to listen music. iii) To solve puzzles. iv) Scribbling with colourful crayon. v) Blocks (putting in the container & stacking) 2. Differential reinforcement of alternative behaviour Social rewards like – clapping, patting at the back, saying good were given for the above activities. The above intervention was implemented for 5 days in the classroom setting. A record of problem behaviour ‘tongue biting’ was kept during intervention session. During the intervention, the frequencies of behaviour were recorded in Table-2 and shown by figure-1(B). Baseline Phase-2 The intervention phase-1 was withdrawn on the 11th session to collect baseline phase-2. The baseline phase -2 observations lasted for 5 sessions. The condition of the baseline phase- 2 was kept same as of baseline-1 to maximum extent of possibility. The recordings of the baseline phase-2 have been given in Table-3 and Figure-1(C). Intervention Phase-2 The intervention phase-2 was initiated on the 16th session and continued up to the 25th session. The intervention phase-2 was implemented in the same manner as intervention phase-1. The recordings of intervention phase-2 have been given in Table-4 and Figure-1(D). Follow up The assessment for follow up was carried out in the same setting as baseline. During the assessment, the investigator simply observed the problem behaviour without any intervention. The recording of the problem behaviour ‘tongue biting’ has been given in Table-5.
Results & Discussion In the present study an attempt was made to control the problem behaviour ‘Tongue Biting’ observed in Mr.BrundabanMaharana, an 11 year old boy with severe mental retardation. The behaviour management programme was conducted following A1B1A2B2 design, i.e. Baseline phase-1 for 5 sessions, Intervention phase-1 for 5 sessions, Baseline Phase-2 for 5 sessions and Intervention Phase-2 for 10 sessions. The intervention programme to control the problem behaviour tongue biting was started in the phase B1. The B1 continued for 5 sessions and the frequency of problem behaviour was recorded. The rate of problem behaviour in this phase ranged from 20 to 23 with .69 of frequency per session in the 6th session resulted in a level change in therapeutic direction. As the intervention continued up to the 10th session, the trend turned into designed therapeutic direction. The rate in the intervention phase -1 ranged from 3 to19with 0.37 of frequency per session. The rate
57 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 consistently decreased from the 6th to 10th session. This further substantiated the functional relationship between intervention and rate of behaviour. The intervention phase-1 was withdrawn in 11th session. As a result the rate of problem behaviour in baseline phase-2 increased substantially compared to rate of intervention phase-1 (Table-2). On the 16th session the intervention was once again introduced. The application of intervention again resulted in decreased rate of behaviour. The rate of problem behaviour in the 23rd to 25th session remained at zero level indicating substantial reduction in problem behaviour. The assessment for follow up was carried out in the same city as of base line and intervention. During these assessments, the investigator simply observes the problem behaviour without any intervention. The first assessment was carried out after one month of last session of intervention phase-2. The subsequent sessions were conducted on alternate days from the 26th to 30th session (Table-5). It was found from the follow up that the problem behaviour is decreased to zero level during intervention, has increased after one month gap. It may be concluded that the intervention in the form of rescheduling of activities and differential reinforcement of alternate behaviour was effective in substantially reducing the tongue biting behaviour of the subject. Further intervention will be necessary to maintain the acquired gains. References Edward A.K. and MosesR.J. (1989) The use of brief restraint plus reinforcement to treat self- injurious behaviour. Behavioural residential treatment, 4(1), 45-52. Han-leong G. And Brain A.I. (1994) Behavioural persistence and variability during extinction of self- injurious maintained by escape. Journal of Applied Behaviour analysis, 27(1), 173-174. Peshawaria R. And Venkatesan S. (1992b) Behavioural approach in teaching mentally retarded children: A manual for teachers National Institute for the Mentally Handicapped, Secunderabad. Peshawaria R. And Venkatesan S. (1992a) Behavioural assessment scales for Indian children mental retardation children: National Institute for the Mentally Handicapped, Secunderabad. Peshawaria R. And Venkatesan S. Mohapatra B. And Menon D.K.(1990) Teachers perceptions of problem behaviours among mentally handicapped persons in special school settings. Indian journal of disability and rehabilitation, 4,1,23-30. Randoll D.B., Steven L.D.; Treadway J.T. and Marshall T. (1995) Opiate antagonists for recurrent self- injurious behaviour in three mentally retarded adults.Psychiatric services, 46 (5) , 511-512.4. Robert M.L., Mace,F.C.andDaggett J.A. (1995) Preliminary comparison of two negative reinforcement schedules to reduce self injury. Journal of Applied Behaviour analysis, 28(4), 579-580.
58 SHARING EXPERIENCES OF ELDERLY ININSTITUTIONALISED CARE SETTINGS: A QUALITATIVE STUDY Divi Tara* Dr. Mamata Mahapatra** Introduction Once a Collectivist culture the Indian society is now adopting a more Individualistic Worldview, it is still debatable if changing value systems are strengthening people and making them more resilient or simply leading to lower levels of mental, social, spiritual and physical health. Hence in such a flux, the most growing population that needs immediate care and attention is that of the elderly. Worldwide as per the United Nations old age is seen as persons who have attained an age of 60years and above. Population that is ageing although reflecting tremendous advances in the field of health & medicine in terms of life expectancy and the overall quality of life of the elderly people across societies can no longer be ignored. A report jointly brought out by UNFPA (United Nations Population Fund, 2007) and Help Age International stated “India has around 100 million elderly at present and the number is expected to increase to 323 million, constituting 20 per cent of the total population.” At present with India‘s population being aged less than 30years (Government of India, 2011), the problems of the growing grey population have not been given much consideration. Major attention currently is being focussed on the children and the youth of India and the fulfilment of their basic needs competing with the growing economy. The traditional Indian society has been able to safe- guard its population through its support structures of joint families and community living, but the dwindling structures of the society are leaving its elderly in a vulnerable state in terms of physical, emotional, mental, economic and spiritual well- being. With lower death rates and increased life expectancy due to advancements in medical and health facilities along with the growing economic market, the cost of living and maintaining health or even accessing a health care facility are also increasing. AtulGawande in his book called “Being Mortal” has rightly stated the fact that, “scientific advances have turned the process of ageing and dying into medical experiences, matters to be managed by healthcare professionals (Gawande, 2014).” All of these changes are placing a lot of pressure on the earning population resulting in deterioration of social structures; more and more nuclear families are evolving, children relocating to distant places, children not being able to give enough time and attention to the elderly, elderly feeling like a burden on their children because of the high expenditure for healthcare corroborating to which news reports suggesting children abandoning their parents in care institutions. It has also becomes a fast growing trend of children migrating overseas due to job requirements leaving their elderly parents either to live alone or to be taken care of by a nurse or a care taker.
*PhD Research Scholar,Amity Institute of Psychology and Allied Sciences,AmityUniversity,Amity University, Noida,Uttar, Pradesh. E-mail:[email protected] **Dr.MamtaMahapatra, Associate Professor,Amity Institute of Psychology,AmityUniversity,Noida,UttarPradesh, E- mail:[email protected] 59 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
In such scenarios several elderly have reported to choose to stay at an old age home for safety and security reasons. They fear the growing rate of crimes and feel they are vulnerable and may be unable to protect themselves when in need (Srikrishna, 2006). A research study by ArunaDubey (2011) conducted on elderly persons living in institutionalised care in comparison to the elderly living with families have revealed a prevalence of estranged social relations amongst family members. Most elderly of the study also reported a lack of respect towards the elderly by the younger generation and they feel an attitude of neglect towards them has developed. It was also seen that women that were living with their children and families reported a greater satisfaction and happiness in life as compared to the elderly women living in the old ages homes of Jammu. The status of elderly who have no family, have no means of support and have no system of dependence is increasingly giving rise to institutional care settings as a means of pseudo- support. Co-relating to the same ,several news reports (Economic Times, 2012) have also shown a rise in the number of old age institutions being built for the care of the elderly with most of them being private institutions with skyrocketing prices and government institutions being very minimal, especially in Northern India where places like Assam are now witnessing their first government old age home built in the year 2012.A research conducted by Ngo Daada- Daadi (2009), revealed that there are about 728 old age homes all over India out of which proper information is available for only about 547 of them and while 325 in these are free of cost the remaining charge per person. Given by the National Portal of India; a single window access to information given by several government entities, is a list of all the government run old age homes in India. With Tamil Nadu having a total of 10 old age homes and Delhi having only 4 such homes these states are far from developing in this social context in comparison to Kerala ranking the highest with 130 old age homes. Even states like Gujarat and Kolkata have around 18-34 old age homes. However, states like Assam have been unfortunate in this matter and have only recently witnessed their first government run old age home inauguration in Guwahati on 2nd October 2012. Immediate interventions and policy programmes cannot be implemented unless the gap between needs of the elderly and emerging areas of concern is covered which requires great resources and studies on the elderly, their needs and their quality of life which at present in India there is a dearth of. Rationale: In light of the preceding discussions on the emergence of institutionalised care settings for the elderly, the conditions that lead to the elderly seeking old age homes, the process of ageing along with the related problems as a global and local reality, the rationale of the study stems from the fact that old age has been identified as the later part of life with a growing dependence of the elderly on their children in terms of social, economic, emotional and physical factors. Since old age is a shifting context with such vast developments all around the globe; the United Nations has agreed to consider 60+ as old age. Institutionalised care in this study refers to old age homes/ ashrams also referred to as retirement places where the elderly reside commonly with several other elderly people and are 60 Tara & Mahapatra / Sharing Experiences of Elderly taken care of by attendants if opted for. Such places are increasingly becoming a common housing option for senior citizens with high levels nursing care, food and accommodation at a twenty four hour basis. All needs of the people are addressed here ranging from a medical practitioner attending to them at regular intervals, to help with bathing and other daily activities. Several researches and studies have tried to assess the susceptibility of mental and physical illnesses amongst the elderly but very few have qualitatively and adequately reported the actual experiences of this population ranging from their acceptance and outlook towards old age in itself, to living in institutions and awaiting a lonely death. Under these circumstances it is of utmost importance that the government develops and implements more social welfare policies and schemes to combat this situation appropriately. The present study aims at understanding the ageing experience of the elderly population living in institutionalised care also called the ‘old age homes’ and tries to qualitatively assess their quality of life, in Delhi and Chennai, to enable the government and various other stakeholders to help provide the elderly with appropriate care, services and schemes. Further, it elicits the primary reasons behind them living in such institutions. Lastly, it aims at understanding the coping strategies adopted by these individuals and to be followed by recommendations based on their needs. Hence, our understanding of the life situations and experiences of these elderly people in institutionalised care is imperative to bring about changes and implementations. Objectives: 1) To understand the experiences and assess the quality of life of the elderly living in institutionalised care. 2) To explore the reasons behind the elderly living in institutionalised care. 3) To explore the challenges and the coping strategies adopted by them. Review of Literature: In light of the preceding theories, review of literature has been cited under the following sections: Reasons for the elderly to migrate to institutionalised care settings, Challenges faced by the elderly in such settings and the quality of life of the elderly residing in elderly care settings in India. Reasons for the elderly to migrate to old age homes: A study done in the Bindapur old age home (Lalan, 2014) of TilakVihar, Delhi, aimed at finding out the reasons for the elderly to move into old age homes. The home is government run, accommodating 60 residents, men and women both aged 60 or above. Admission in the home is done on a voluntary basis and all relevant documents are checked before shifting into the home. The old age home provides all necessary facilities such as lodging/ boarding, bedding, clothing (optional), food, and also facilities such as radio, medical doctor, tv, kirtans/bhajans. The findings of the study reveal that majority of the members had estrangedrelations with their family members and supporting studies have assigned this increased shift to old age homes due to carelessness by family members. 40% respondents of the study reported conflict with the son as the major reason for shifting into a home followed by 30% elderly who had no one to
61 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 take care of them. About 5 % reported the need for independence as the reason for moving out and about 40 %males and 36% females have moved into the home due to stress. 25% shifted as they had no sons and did not want to move into their married daughter‘s house. There were more women in the home than men and most of the women had always done household work. They did not have any source of income and have always been dependent on family. The study clearly indicates that the reasons for the elderly in Delhi to migrate to old age homes are mainly due to conflicts with the children primarily the son and they suffer great stress at home. The elderly also report to choose old age homes as they feel neglected at home and have no one to look after them. Arising from this need of family dependence a study conducted in Odhisa (Syamala, 2012) was aimed at finding the living preferences of the elderly and what made them migrate to old agehomes. The findings of the study showed that 87% of the elderly moved into the home due to ill health and about 82% of them shifted due to lack of funds to support themselves. Followed by these reasons family conflict and having no children were also some of the reasons for the elderly to choose the homes. 44% of the elderly were living alone or their spouse had died. Interestingly it came to light that more men reported conflict with family and thus chose to live at the home. A study on similar lines was conducted in an old age home in Bhopal (Tripathi, 2014), aimed to get a view of the elderly on adjustment into old age homes. The results of the study showed that around 15% of the respondents had no economic support as they had divided their property according to the number of children they had and most children had also used their pension savings. The elderly in the home feel insecure of their future having no assurance of consistent economic support from their children. Having no guarantee of a future can be the most terrifying feeling and to have such a feeling in this late stage of life is a misery written in the lives of many elderly in India. Feeling helpless and uncertain must cause great distress and anxiety in the elderly and can be deduced as the cause for most ill health of the elderly in terms of both physical and mental health. Challenges faced by the elderly living in Institutionalised care: Challenges faced by the elderly residing in institutionalised care settings often range from adjusting into a new place (develop a liking for the food and the services provided by the institution) to learning new ways to cope with the newly gained independence in terms of physical, financial and emotional support to coping with the loneliness and in some cases depression that is often followed by the demise of spouse. A research (Vanitha, 2014) based to understand the problems face by the elderly in institutionalised care and the role played by the old age home in that problem was done in Kerala. Interestingly, the findings revealed that the most common problem faced by majority of the elderly was in adjustment with other residents of the home. The author also suggested that as the respondent‘s age increased their level of adjustment also increased. It was also observed that 25% of the respondents were sad and waited for an impending death. Although the rate of mental disorders was not as high as physical problems amongst the elderly and majority of the men suffered more than the women in the homes. It is not surprising that adjustment is a core
62 Tara & Mahapatra / Sharing Experiences of Elderly challenge as after years of establishing and living in a comfortable home with family, at times change with sudden compelled decisions can be rough. With age adjustments in newer surroundings with a variety of new people can pose complex institutional challenges resulting in being isolated and having difficult relationships and a sense of sadness. A study on similar lines was conducted in an old age home in Bhopal (Tripathi, 2014), aimed to get a view of the elderly on adjustment into old age homes. The results of the study showed that around 69% of the elderly had lost their partners and faced adjustment issues at the home. Most elderly complained that there was no source of entertainment for them at the home which caused a more sullen atmosphere. They also complained of things such as no outings, no choice or variety in food, no privacy. Most elderly did not have anyone visiting them but it was observed that most of them were fond of talking about their grandchildren and remembered them often. From the study it can be deduced that elderly persons in institutional care settings missed their life style and they had when living at home. The elderly in such settings are not provided with many options and the loss of control feels like a harsh reality. They seemed to connect most to their grandchildren and are content when efforts are made from the family to visit them on regular intervals. Quality of life amongst the elderly living in old age homes: A study aiming to assess the quality of life of the elderly was done in Lucknow (Abhishek Gupta, 2014). The results of the study indicate that 63% of the population in private old age homes reported an above average quality of life, contrary to the public institutions where about 85% of the population had a quality of life that was below average. Their findings also show that backward sections of the society still weigh low financially as the homeless elderly in that population has no access to any facilities of the private old age homes. No person to take care of the elderly persons at home was a primary reason for them to move to an institutionalised care setting but in public old age home there still was no one available. It was also noted that most elderly in the private old age homes were educated while those in public care settings were up to primary pass. From the findings it can be deduced that the quality of life of the elderly was better for those elderly who were able to access private old age homes in comparison to those who were living in public care institutions. It can also be understood that the socio- economic background of the elderly played a critical role in the quality of life and those with a better socio- economic status possibly had a higher quality of life prior to living at the institutional care setting. Another study undertaken in on the elderly living in institutionalised care setting in Chandigarh (Kaur, 2014) aimed at finding out the life satisfaction amongst inhabitants of old age homes in Chandigarh found that out of 50 participants more than half attained a moderate score on psychological well- being. The study also found marginal depression prevailing amongst nearly half the participants. All participants belonged to a middle socio-economic background and came from an urban living style and nearly 80% of the participants were literate. It can be deduced from this study that unlike the previous studies discussed, being literate or being from a middle or s stable socio- economic background may not necessarily have a positive impact on the life satisfaction and the well- being of elderly persons living in institutionalised care settings.
63 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
The psycho-social well- being of the elderly are affected at other levels also such as spiritual satisfaction, acceptance of the aging process etc. and the institutional care settings must keep in mind the same and provide an outlet for the same. Research Methodology A. Research Design The present research was a Qualitative Study exploring the experiences of the elderly living in institutionalised care. The study took a constructivism approach hoping to get a better understanding of the different social constructs the elderly living in old age homes have made for themselves and how they view their life. The end goal of the research wasto analyse the quality of life and experience of people living in old age homes. A case study methodology is also used to interpret and analyse the data taken from two organisations, that is, old age homes in two of the Metro cities,Delhi and Chennai, wherein both organisations are looked at as separate cases. B. Procedure of study conduction: Data collection of the study was done in two parts. The first half of the data collection was done in Delhi over a period of 2 months spending approximately about 1 hour with every individual participant. The second half of the data collection was done in Chennai over a period of 2 months with the help of a colleague to help with the translation of the Tamil speaking participants. The researcher first had to attain permission from both the organisations to conduct a research interviews with the people of their organisation. For this purpose the researcher met with the managers of both organisations and explained to them the purpose and nature of the study. The researcher had to assure the organisations that no harm would be caused to their residents before, during or after the study. The researcher had to convince the organisations that she was not in position to share any information provided to the researcher by the participants although she would give the organisation the final recommendations of the study. After gaining permission from the managers the permission has also been taken from the residents of the old age homes. The Researcher individually addressed all residents and explained to them the purpose and nature of the study. The researchers also cleared all doubts asked by the participants and ensured them of the confidentiality of the whole research process. The participants were also safeguarded that any information provided by them would have no impact on their stay at the organisation, before during or even after the conduction of the study. Data was collected from old age homes in Delhi and Chennai. First an informed consent form was given to each participant and explained the importance of their consent for the conduction of the study. If any of the participants was unable to sign oral consent was taken. Methodology of data collection 1. Administering the questionnaire: A quality of life questionnaire called the CASP- 19, designed specially to measure the quality of life of the elderly, was introduced to each participant. It was explained to the participants what the questionnaire aims to assess and how the answer options were given. Any doubts in relation to the questionnaire were cleared and if the participant was unable to mark the answer on their own, the statements were literally translated along with
64 Tara & Mahapatra / Sharing Experiences of Elderly answer options and the answers were marked. The CASP-19 aims to cover four broad domains in the lives of the elderly, namely: Control, autonomy, self- realisation and pleasure. The items have been developed in such a way so as to enquire the person regarding his views about his life in these four domains. 2. The interview process: Following the administration of CASP-19 on all residents of both the homes (Delhi & Chennai) the study used open ended questioning technique for the in- depth interviews engaging participants in a conversation about how they came to be in the institution; who referred the place to them/ what their reasons were, what challenges they faced living at the institutional setting. The in- depth interviews were conducted with 20 participants, 10 in Delhi and 10 in Chennai. Several participants were apprehensive to give any information fearing their dismissal from the home and had to be reassured of the confidentiality of the process and that there was no pressure on them to share anything they didn‘t not wish to disclose. This was done to ensure the safety of information provided by the participants while also assuring them that the research intends no harm towards the participants or does not interfere in any way with their daily living at the homes. 3. Focus group discussion process: In the final phase, the research aimed at understanding the strategies adopted by the elderly to cope with the challenges that the elderly faced living at the institutionalised care setting. For this the researcher involved 5 elderly men from the organisation in Delhi to engage in a focus group discussion. The researcher was able to conduct a focus group discussion of half an hour each due to inability of many participants to gather at particular timings and their physical restrictions. Most of the women at both the homes suffered from physical ill health which in turn limited their participation. Tools Description C.A.S.P-19 This quality of life construct conceptualises four domains of need; control, autonomy, self- realisation and pleasure. Control refers to the ability of an individual to actively intervene in his environment. Autonomy is the ability of an individual to make his own decisions and be free from the unwanted interference of others. Pleasure is an active process of being human. Self- realisation referring to Maslow can be defined as the ability of an individual to use his full personal potential & achieve a state of fulfilment. Each domain consists of four point adverbial scale agreement items, for example ‘I look forward to each day’ indicated by often, never, sometimes and always. In total there are 19 items, which are summed to form the overall score. The range of the scale was from zero, which represents a complete absence of quality of life, to 57, which represents total satisfaction across the four domains. In depth interviews with open ended questions were conducted with a sample of 20 elderly (10 Delhi & 10 Chennai) persons asking them the following questions: Section 1: 1) Where have they lived for all these years of their life? (Tracing origins) 2) How has their socio-economic status been/ fluctuated all these years?
65 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
3) How they came to be in institutionalised care, reasons for selecting to live in elderly care institutions. Section 2: 4) What difficulties do they face in the current setting? Give examples. 5) How did they pass their time in the current setting? 6) Describe their quality of life at the current setting? Data Analysis: The data analysis for CASP-19 of the study was done by calculating the aggregate mean scores of all participants from Delhi and Chennai. Data for the open ended interviews and focus group discussions of the study was noted tracing common themes across both cases, and presented as institutional cases. Results & Discussion: The aim of the present study was to assess the quality of life of the elderly living in institutionalised care settings and to understand the reasons for the elderly for moving into care homes. The study further aimed at understanding some of the challenges that the elderly face living in such institutions and the strategies adopted by them to cope with their daily life problems at the institution. The results and discussions in this chapter are presented in 4 parts. From part 2 to 4 the results & discussion are supported by anecdotal references: Part 1: Presents results on the quality of life elderly living in elderly care homes in Delhi & inChennai via data obtained from CASP-19 scale (Richard D. Wiggins, 2004) The data was analysed by calculating the mean scores of the participant responses on the CASP-19 questionnaires. Table- 1 Displays the mean scores of both the institutions:
State of Institution Mean Scores
Delhi 39.4
Chennai 37.2
The above scores represent the quality of life of the elderly living in both the institutions. It can be inferred from the data represented in the above table that elderly people living in an institutional care setting in Delhi have attained a mean score of 39.4 on the CASP-19 indicating that they enjoy an almost average quality of life. The data from Chennai presents the mean score of the elderly people living in an institutional care setting and have attained a mean score of 37.2. It can be inferred from the data that the elderly living in institutional care settings in Chennai have a below average quality of life in comparison to those living in institutionalised care in Delhi. Average can be understood as 50% or almost half; in terms of quality of life the 66 Tara & Mahapatra / Sharing Experiences of Elderly elderly living in institutional care settings enjoy a quality of life that is almost half as good as it should be.The findings revealed that the elderly living in institutionalised care in Delhi & Chennai experienced an average quality of life. In Delhi the quality of life indicators were under the domains of pleasure & self- realisation which meant that the elderly in institutionalised care setting in enjoyed a life with more happiness & satisfaction and were more acceptant of their situations, on the other hand in Chennai, the scores under the domains of autonomy & control were found to be higher in comparison to Delhi, indicating that the elderly living in institutionalised care setting in Chennai enjoyed more control in their daily living at the institutional care setting and were more autonomous in making their choices and decisions.Hence while the quality of life of residents was average the variation was seen more in the domains of quality of life Part 2: Presents results on the reasons for elderly to move into institutionalised care in Delhi and in Chennai via open ended interviews Across both the institutions, the common reasons for shifting to an elderly care setting were primarily based on economic insecurity arising from lack of stable social structures. Most elderly in Delhi lived single and independently prior to residing at the institutional care setting and had no extended family back- up, thus leaving them alone and incapable to care for themselves in their old age, and selecting the institutional care setting to become their only alternative to living besides home. For many elderly death of their spouse was another precipitating factor causing their shift to institutionalised care setting. Being rendered single all their lives or having lost their spouse was the primary reason to move into the institutional care setting in Delhi. The choice of shifting to an institutionalised care setting in Chennai on the other hand was catalysed by the changing social structures with migration of children abroad for better professional opportunities and round the clock working hours because of the increased labour demand. Most of the elderly in Chennai chose the care institution despite having a home of their own in the city. Most elderly had working children and had no system of support for their care and day to day management. A clear distinction that prevails in reasons for admitting themselves to elderly care institutions in Chennai was lack of support from the extended family while in Delhi it was the lack of an extended family. Pertaining to this lack of social structure the elderly found it increasingly difficult to bear the cost of living alone with the high rising prices of medical treatments making the elderly at both the institutions burdened with financial difficulties. The elderly in Delhi, having minimal to no family or hardly any form of social support had to sustain themselves without any external monetarily in flow. Most of them managed their expenses either on their own pensions while some sustained solely on their late partner‘s pensions. The financial aspects were better handled by the elderly in Chennai despite the lack of interaction and connection with the children on a regular basis, the elderly in Chennai received regular payments and financial support from their children on a monthly basis and did not worry much about the financial needs.
67 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Moreover, the changing social structures have not only caused a sense of economic insecurity amongst elderly, but also caused a sense of insecurity with regard to their safety with growing age. While the major burden of financial difficulties was dealt with elderly in Delhi, the elderly in Chennai deal with the burden of safe guarding themselves from the various tormenting factors of the society. Part 3 Presents results on the challenges faced by the elderly living in institutionalised care inDelhi & in Chennai via open ended interviews Across both the institutions, the common challenges faced by elderly persons living in institutionalised care setting were primarily based on economic insecurity arising from lack of stable family- social structures. Most elderly in Delhi lived single and independently prior to residing at the institutional care setting and had no extended family back- up, thus leaving them with minimal resources to seek help from. For many elderly death of their spouse was another precipitating factor leading to scarcity of financial resources and being dependent on their late spouse‘s pensions. Being rendered single all their lives or having lost their spouse made the elderly very vulnerable in terms of economic constraints and faced the challenge of managing their finances at the institutional care setting in Delhi. The economic burden at the institutionalised care setting in Chennai on the other hand was catalysed by the changing social structures with migration of children abroad for better professional opportunities and round the clock working hours because of the increased labour demand. Most of the elderly in Chennai were unable to manage their home in the city which required assistance in the form of cleaners, gardeners etc. along with increased medical expenses. Most elderly had working children and had no system of support for their care and day to day management. Though the challenges faced by the elderly at both institutions are the same, a clear distinction that prevails in their challenges in Chennai was lack of support from the extended family while in Delhi it was the lack of an extended family. Pertaining to this lack of social structure the elderly found it increasingly difficult to bear living alone and elderly at both the institutions suffered from loneliness. The elderly in Delhi, having hardly any form of social support long to meet their social needs and engage themselves in a social community. Most of the elderly resorted to doing solo activities and some who were physically able managed to engage with a group every now and then. The loneliness was better handled in Delhi in comparison to the elderly in Chennai, supposedly because of the independent lives the residents in Delhi had lived prior to admitting themselves institutional care. The elderly in Chennai on the other hand were more tormented with the unbearable loneliness that set in after the migration of their children. Having a big family only to be displaced all around gave the elderly a sense of despair and longing for the joyous past days to return and many often sighed about the helplessness this causes to them. Part 4 : Presents results on the coping strategies adopted by the elderly living ininstitutionalised care in Delhi & in Chennai via focus group discussions
68 Tara & Mahapatra / Sharing Experiences of Elderly Across both the institutions, the common coping strategies adopted by elderly persons living in institutionalised care setting were primarily based on engaging themselves arising from a deep rooted sense of loneliness. Most elderly in Delhi lived single and independently prior to residing at the institutional care setting and had no extended family back- up, thus leaving them unable to share their stories and engage in any social contact. For many elderly death of their spouse was another factor leading to loneliness and a feeling of despair. Being rendered single all their lives or having lost their spouse made the elderly very vulnerable in terms of social and intimate support at the institutional care setting in Delhi. The burden of loneliness at the institutionalised care setting in Chennai on the other hand was catalysed by the changing social structures with migration of children abroad for better professional opportunities and round the clock working hours because of the increased labour demand. Most of the elderly in Chennai were away from their families and those who did have families felt unwanted by their children as they were unable to keep up with increased medical assistance & expenses. Most elderly had working children and had no system of support for their care and day to day management. Though the challenges faced by the elderly at both institutions are the same, a clear distinction that prevails in their challenges in Chennai was lack of support from the extended family while in Delhi it was the lack of an extended family. Pertaining to this loneliness the elderly try to cope with it by occupying themselves and engaging in activities. Most of the elderly resorted to doing solo activities like reading, writing, television, radio and some who were physically able managed to engage with a group every now and then in Delhi. At the institutional care setting in Chennai the activities were mostly solo or done by those with living spouses. Most elderly at the institute spent their time sleeping or resting in bed because of their severe physical limitations. Mental Health Implications of the elderly residing in institutionalised care settings: The following discussion is based on the inferences drawn from the data obtained through various means. Defined by the World Health Organisation mental health is a state of well-being in which each individual realises his or her own potential, can cope with the normal stressors of life can work productively and fruitfully, and can make a contribution to his/ her community. Although it is debatable what normal stressors of lifeare, as they are subjective to every individual. In the context of this definition the mental health implications of the study have been inferred from the data obtained through the open ended interviews and focus group discussions covering the reasons, challenges and coping strategies of the elderly persons living in institutionalised care settings; in Delhi & in Chennai. Most of the elderly in both the institutionalised care settings suffered from physical ailments, some having severe bed- ridden ailments while some where still able to walk on their own. Majority of the elderly in the institutionalised care setting in Delhi paid for their accommodation and services through their pensions or the pensions of their late spouse. All the elderly in Delhi were living alone and a majority of them barely had any relatives or visitors. Majority of the elderly in Chennai were paid for by their children who were living abroad or in distant cities. Most of the elderly were living alone and a few were with spouse.
69 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
The common theme arising from the interactions with elderly persons of both institutionalised care settings were loneliness, boredom and helplessness- the plagues of institutionalised care settings. A sense of pervasive loneliness coupled with a growing insecurity about the self and the future of self can put one under the risk of mental ill health regardless of age. Undergoing turmoil about life overall, or as understood by Erikson the stage of integrity v/s despair, the sense of having no one to share the emotional burden with can cause a sense of immense sadness amongst the elderly. The elderly group often have multiple co-existing issues pertaining to their bio-medical and psychological well-being proposing them as vulnerable. Under such strenuous circumstances the prevalence of chronic depression is rampant amongst the elderly population living in institutionalised care settings (Shaji, 2007).In the event of no alternatives for residing; these elderly care institutions seemed to have become a viable option. The concomitant effects of having the desire, but not having the option of living in their own homes, resulted in pervasive helplessness and acceptance of their situation as a forced choice, with few instances of optimal happiness affecting the quality of life of the elderly living in institutional care settings. The mental health implications indicate that long term institutional care settings where quality of life is moderate or average are predictors of gradual mental health decline and manifest in symptoms like psycho-somatic illnesses, morbidity, lack of hope for living and despair. Chronic mental health problems such as depressions, anxiety and suicidal ideations also seem to manifest in the elderly despite the futility of acceptance of the aging process. Conclusion: It can be concluded from the above findings that though physical health is an important determinant of quality of life it is not the only challenge that determines the quality of life amongst the elderly living in institutionalised care settings. Emotional fulfilment is also an important aspect of consideration. The eroding social structures have placed the elderly in a greatly vulnerable state in terms of social, emotional and economic support, which proposes an even bigger challenge. With the majority of elderly population sustaining on manual labour in India as suggested by United Nations Population Funds studies only a few thousand elderly are on pensions. The rate of living is lower in the institutional care setting in Delhi that is in the form of a one- time deposit as compared to the institutional care setting in Chennai that has a monthly payment system. The elderly in Delhi struggle to manage their finances as most of them are living on a pension or their late partner‘s pensions on the other hand the struggle is more in terms of social adjustment in Chennai where a majority of the elderly are dependent on their children to send money and those who have strained relationships worry that someday their children might not pay their rent and wonder where would they resort to in such a scenario. Loneliness is a major problem for the elderly at both institutions as majority of the elderly at both the institutions are assigned to bed- rest and have restricted mobility leaving very few who muster the strength to walk around. Solitude is a constant in the lives of the elderly; for those who have an extended family back up some days are of utter happiness and joy as they seek comfort in the warmth of their grandchildren and children who come visit them once a year or in some cases monthly. Some elderly whose children live within the city await the single day of the week when their children would come to meet them and sometimes even those days
70 Tara & Mahapatra / Sharing Experiences of Elderly are cut out of schedule due to prior appointments of the children or wanting to spend a weekend with their family, inflicting a sense of being unwanted or not belonging to the family. These emotional changes in old age are to be dealt with very sensitively and not like the findings in the institutional case under study in Chennai where some of the care takers were abusing the elderly in terms of physical and verbal violence. The elderly find solace in occupying themselves and engaging in activities mostly pertaining to self or at minimum share a word with their next door neighbours. In today‘s time an institutionalised care setting may not necessarily be adverse or damaging as an experience. The problems of the elderly population are quite specific and context related. In institutionalised care settings the provisions of infrastructure facilities are necessitated but are not compensatory to the paucity created by unstable social structures and support systems. Lack of emotional and social engagement & stimulation nullifies the effect of other provisions of care offered by such settings and eventually precipitates further feelings of loneliness and a lack of belongingness. Hence in such a scenario understanding the emotional needs and the sustenance of the needs of the elderly by simply even acknowledging them as subjective beings able to have a say in matters, capable of having desires and a hope for the future despite the many losses they undergo is of the essence. The following recommendations have been made to the institutional care settings in Delhi & Chennai. Recommendations: Institutions need to think about the group activities and focus on building a culture within the institution that alleviates loneliness. Providing for sources of entertainment and group engagement for the residents of the institutional care settings such as having a library, movie nights, laughter clubs and promoting more recreating outdoor activities such as to the beach/ to the mall/ movies for the residents of such institutional settings etc. The institutionalised care setting must also look at addressing the emotional well-being and emotional requirements of the elderly. This can be done by having an on-call counsellor for the residents or having a source of emotional ventilation for the elderly. The facility must also look at providing activities for intellectual stimulation for the elderly by encouraging activities such as playing cards, Sudoku, puzzles etc. Providing facilities such as electricity and accommodation at subsidised rates Understanding the needs and requirements of the elderly for food preparations, giving them the choice to decide the menu. Engagement of residents in activities within the institutional care settings such as engaging residents in supervising the kitchen, cleaning, laundry and other facilities of the institution. Utilising the experience and services of the elderly to become part of the decision making process in the homes, participatory involvement of the residents to claim more ownership of the institutional setting. Keeping the staff resident ratio equivalent.
71 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Institutions need to think of enabling more family support and provide activities inviting family members to the institutional care setting such as having a family day once a month or having a system of letter writing weekly. Institutions can look at providing one on one conversation with the elderly residents in by recruiting volunteers/ groups on a monthly basis to develop healthier communication and mitigating the sense of loneliness. To involve other stakeholders like people in civil society, members of organisations social/ religious to be more involved personally than transaction based References Government of India.(2011). Demographics of India. Retrieved February 20th, 2016, from https:// en.wikipedia.org/wiki/Demographics_of_India: https://en.wikipedia.org/wiki/ Demographics_of_India Indian Express. (2012, October 2nd). First Government Old age home in Assam. Indian Express. United Nations Poulation Fund.(2007). Retrieved from www.unfpa.org/ageing. Elderly choose old age homes over their kid’s homes. (2015, July 6). Times of India. Abhishek Gupta, U. M. (2014).Quality Of Life Of Elderly People And Assessment Of Facilities Available In Old Age Homes Of Lucknow, India. National Journal Of CommunityMedicine, Page 24. ArunaDubey, S. B. (2011). A Study of Elderly Living in Old Age Home and Within Family Set-up in Jammu.University of Jammu. Census.(2011). Government of Australia. Retrieved February 22, 2016, from http://www.abs.gov.au/ ausstats/[email protected]/Lookup/2071.0main+features602012-2013: http://www.abs.gov.au/ausstats/ [email protected]/Lookup/2071.0main+features602012-2013 Cohen, L. (2011). No Aging in India. New Delhi: Oxford University Press. Cracknell, R. (2010). Parliament of U.K. Retrieved February 23, 2016, from http://www.parliament.uk/ business/publications/research/key-issues-for-the-new- .S.Chandrika, D. D. (2015). Quality of Life of Elderly Residing in old Age Homes and Community in Visakhapatnam City. IOSR Journal of Dental and Medical Sciences. DubeyAruna, B. S. (2011). A Study of Elderly Living in Old Age Home and Within Family Set-up in Jammu.University of Jammu. Economic Times.(2012, October).Economic Times. Encyclopedia.(2007). History of Nursing Homes. Retrieved from http://medicine.jrank.org/pages/1243/ Nursing-Homes-History.html: http://medicine.jrank.org/pages/1243/Nursing-Homes-History.html Gawande, A. (2014). Being Mortal- Medicine & What Matter’s In the End. New York. HelpAge India. (2011). HelpAge India Retrieved from http://www.helpageindiaprogramme.org/Elderly%20Issues/ problems_of_the_elderly/index.html. HelpAgeIndia(2011). http:// www.helpageindiaprogramme.org/Elderly%20Issues/problems_of_the_elderly/index. html. Retrieved from Help Age India. India, T. o. (2010, June 16). Neglect of the Elderly high in Chennai: Report. Times of India. Joshi, M. (2008, March 8). The Economic Times. Retrieved from http:// articles.economictimes.indiatimes.com/2008-03 08/news/27710924_1_smokers-researchers-pleasure: http://articles.economictimes.indiatimes.com/2008-03-08/news/27710924_1_smokers-researchers- pleasure 72 Tara & Mahapatra / Sharing Experiences of Elderly
K.S., L. D. ( 2013 ). Quality of Life of Elderly Men and Women in Institutional and Non- institutional Settings in Urban Bangalore District.Research Journal of Family, Community and ConsumerSciences. K.S., L. D. (2013). Research Journal of Family, Community and Consumer Sciences, 7-13. Kaur I., S. N. (2014). Life satisfaction amongst selected inhabitants of old age homes in Chandigarh- A cross sectional study .Delhi Psychiatry Journal. Kunkel Suzanne R., J. S. (2014). Global Aging: Comparative Perspectives on Aging and the Life Course. In J. S. Suzanne R. Kunkel, Global Aging: Comparative Perspectives on Aging and the LifeCourse (pp. 183-189). Springer Publishing Company. Lalan, Y. (2014). A sociological sudy of old persons residing in an old age home of Delhi, India . International Research Journal of Social Sciences. Mason Andrew, L. R. (2004). Reform and Support Systems for the Elderly in Developing Countries:. Population and Health Studies. MG, M. S. (2013). A Study To Assess The Level Of Stress And Quality Of Life Among Elderly Retired In Selected Urban Community, At Bangalore. Raiv Gandhi University OfHealth Sciences. Moore, M. (2013). China’s ageing population: 100-year waiting list for Beijing nursing home. The Telegraph. N. Sharma, S. I. (2014). Life satisfaction amongst selected inhabitants of old age homes at Chandigarh- A cross sectional survey. Delhi Psychiatry Journal. Nagarajan, R. (2014. 15 million elderly Indians live all alone: Census. The Times of India. National Portal of India.(2011). National Portal of India. Retrieved December 2015, from http:// www.archive.india.gov.in/outerwin.php?id=http://www.pagindia.com/OldAgeHomes.pdf: http:// www.archive.india.gov.in/outerwin.php?id=http://www.pagindia.com/OldAgeHomes. Neelam Pandey. (2015. Bitter and sweet: Delhi’s elderly find space of their own. TheHindustan Times. Oecd. (2013). A Good Life in Old Age?Monitoring and Improving Quality in LongTerm.Journal ofOraginsation of Economic Co-operation and Development. Orr, S. (1994). The Biology of Ageing.In Sohal, the Biology of Ageing. Perappadan, B. S. (2015, July 12). Neglected by kin.The Hindu. Pilling, D. (2014. How Japan stood up to old age. FTM Magazine. Rajeev, M. M. (2015). Elderly In India: A Quality Of Life Of Elderly Persons In Institutional Settings. International Journal Of Developmental ResearchRichard D. Wiggins, P. F. (2004). Quality of life in the third age: key predictors of the CASP-19 measure. Ageing & Society 24, 693–708. Roopa, K. L. (2013). Quality of Life of Elderly Men and Women in Institutional and Non- institutional Settings in Urban Bangalore District.Research Journal of Family, Community and ConsumerSciences, 7-13. S. C. Tiwari, N. M. (2012 ). Mental health problems among inhabitants of old age homes: A preliminary study. Indian J Psychiatry, 54(2): 144–148. Sanner, H. (2013). Old and Alone: Analyzing the Developed andInherent Social Avenues for Elderly in a Modernizing Society. Independent Study Proect. Shaji, T. S. (2007). Demographic aging: Implications for mental health. Indian Journal of Psychiatry, 78- 80. Srikrishna, L. (2006). O ld age homes ‘preferred by many elders’.The Hindu.
73 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Suominen K1, I. E. (2004). Elderly suicide attempters with depression are often diagnosed only after the attempt. International Journal of Geriatric Psychiatry. Syamala, A. K. (2012). Living Arrangement Preferences and Health of the Institutionalised Elderly in Odisha.Institute of Social and Economic Change. Tewari, A. (2009, July). Youth kiAwaaz.Retrieved from http://www.youthkiawaaz.com/2009/07/old-age- problems-india/. The Hindu. (2006, November 25). Old Age Homes the Last Resort of the Elderly. The Hindu. Times, O. S. (2015, June 15). Old-age Homes: Do We Really Care For The Elderly ?OdishaSun Times. Tripathi, P. (2014). Elderly: Care and Crisis in Old Age Home. Irc’sInternational Journal Of Multidisciplinary Research In Social & Management Sciences, 86-90. UNFPA.( 2011). United Nations Populations Fund. Retrieved from http://www.unfpa.org/ageing: http:/ /www.unfpa.org/ageing Vanitha. (2014). Institutional Care of the Elderly: A Study of Old-age Homes in Hassan City, Karnataka, India. International Journal of Interdisciplinary and Multidisciplinary Studies(IJIMS), Vol 1, No.5, 100-107. WHO.(2001). The World Health Organization Quality Of Life Measuring Instruments. World Health Organization.
74 PARENTING STYLE AND CRIMINAL TENDENCY AMONG ADOLESCENTS Cyma Anjum* Ranjeet Kumar** Abstract The study investigated the role of parenting style, Gender and socio economic status on criminal behaviour tendency among adolescents in Muzaffarpur district of North Bihar. A total of 500 participants comprising of 100 students (50 males and 50females).The extravagant life style Assessment Scale(ELAS) was used to test the criminal behaviour tendency of adolescents : Result showed that there was significant difference in parenting style, F(1,488)= 8.60 P< 0.001; Significant gender difference (1,488) =6.41, P<0.001 and significant difference in socio economic status F(2,488)=4.51 P<0.001; Parenting style X Gender interaction effect was statistically significant F(2,488) =3.30,P<0.001; Parenting style X socio-economic status interaction effect was statistically significant F(2,488)=3.123,P<0.001;Gender X socio economic status interaction effect was statistically significant (2,488)=5.05,P<0.00;Parenting style X Gender X socio economic status interaction effect was statistically significant F(2,488)=4.03,P<0.001.The implications of these finding to criminal behaviour tendency of adolescents were discussed. Keywords: Parenting style,Gender, Socio economic status, adolescents, criminal behaviour tendency. Introduction: The attitude of parents toward the up bring of children in our society seem to be creating a lot of social, moral, spiritual and psychological problems. Such problems include delinquency, deviance, criminality, aggression and violent behaviour. Such psychological problems results to stigmatization on such children or individuals. Family is the child’s first place of contact with the world. The child as a result acquires initial education and socialization from parents and other significant persons in the family. The parents indeed are the child’s first teacher and when parents are involved in criminal behaviour, such children are likely to be delinquent criminal and other antisocial behaviour later. Intellectual skills can be developed if parents can show concern about the children education by providing their social, moral and spiritual needs. Parents have a profound influence on whether a home providing intellectual stimulation, physical and psychological safety, and appropriate degree of structure, and supportive relationships. Children with more opportunities at home to build academic, moral, social and spiritual skills tend to be better at integrating family, school and community efforts. Therefore, how good or bad a child turns out to be, depends on the type
*Asst Prof . in Education, L N Mishra College of Education, BRABU.Muzaffarpur, E mail : [email protected] ** R.S.& Guest Faculty of Psychology, RDS.College, BRABU.Muzaffarpur 75 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 of parenting style. According to the psychologists parenting style is the psychological method of bringing up children in family or environment. The parenting style employed by parents lead to the overall development of the child. Parenting styles include (i) Authoritarian parenting: which implies the use of punitive and forceful measure to enforce proper behaviour and it causes anger, resentment, and deceit and impairs wholesome parent-child relationships. Such parenting style results to child dependency syndrome and lack of motivation in girls and results to anger and defiant behaviour for boys. (ii)Permissive parenting style: where the parents are not punitive, they are loving, and accepting, they often have children who lack independence and are selfish because they were not taught how their action affects others. These children tend to be impulsive, aggressive, and low in taking responsibilities. (iii)Neglecting/rejecting parenting style: the parents display low levels of both demandingness and responsiveness. If extreme, it becomes child abuse. The children have low self-esteem and display anger towards others. Many exhibit deviant, delinquent, and antisocial behaviour and may end up as criminals. Hirschi (1969) viewed that the bond between parent and child factored into that child’s level of delinquency and criminality later in life. Building on this, years later, Hirschi (1990) suggested that poor parental management leads to low self-control in children, which leads to subsequent delinquent or criminal behaviour tendency. Juvenile delinquency or criminality is caused by neuropsychological vulnerabilities in children and socialization in a criminogenic environment. This implies that children with neuropsychological deficiencies who are born in criminal environments are more likely to succumb to deviant, delinquent criminal behaviour tendency than those who are born into those types of environment or home. Parenting style is the psychological, moral, spiritual, social and educative processes or method used by a parent in the overall development of the child towards his/her social behaviour. Another variable is gender which involves the psychological and socio-cultural dimensions of being male or female (Bandura, 1977).Gender role is set of expectations that prescribe how females or males should think, act and feel. In the social roles view, females have less power and status than men do and control fewer resources and have lesser deviance, delinquency and criminal behaviour tendency than males. The social cognitive theory of gender emphasizes that adolescents’ gender development are influenced by their observation and imitation of others’ gender behaviour, as well as by rewards and punishments of gender-appropriate and gender inappropriate behaviour(Bandura, 1977). Parents and siblings influence adolescents’ gender roles. Peers are especially adept at rewarding gender appropriate behaviour. Criminal behaviour was further to describe actions relating to antisocial behaviour. This identification of an antisocial personality with criminal behaviour leads to the idea that criminal mischief seems to be more prevalent in males. Although our justice system is heavily loaded with male criminals, women are still part of criminal “world”. It seems that men are much more physically violent than women. A few points are essential when discussing women and violence. First women should not be entirely eliminated from the spectrum of criminality just because of their smaller predisposition toward criminal behaviour or aggression. Second, women are just as capable as men of committing a crime or a violent act. It was discussed how certain neurochemicals are
76 Anjum & Kumar / Parenting Style And Criminal Tendency Among associated with criminal behaviour. These neurochemicals might be more active in men, but women can still grow up in homes or environments in which certain tendencies are brought to. It was also viewed that how poor communication weak family bonds are correlated with the development of aggressive and criminal behaviour tendencies. It was also perceived how a financially unstable family and child abuse or neglect are also associated with criminal behaviour tendency. Parenting environment is important for a child to adult transition. Without proper nurture, guidance, and support, no child, male or female, will learn coping strategies, life skills, or grow up with a strong sense of venues. Whether one is male or females, growing up in unstable family in which one is beaten or neglected may result to serious traumatic experience. The aggressive tendencies in males lead them to become more aggressive in adulthood, which in turn may make them more apt to commit violent crimes or exhibit criminal behaviour. Yet females seem to be known to commit those same crimes. Social-Economic Status: Social- Economic Status: This background refers to parents’ educational attainment, occupation, level of income and social class placement. When a child’s needs are not properly addressed, his social, mental and moral ability could be. References Gottfredson and Hirschi’s General Theory of Crime (Doctoral dissertation, Indiana University of Pennsylvania, 1996). Dissertation Abstracts International, A: The Humanities and Social Sciences, 56(10), 4155-A. Hirschi.; Travis.; 1969. “Causes of Delinquency”. New Brunswick, NJ: Transaction Publishers. Hirschi, T. (1969). “Causes of delinquency”. Berkeley: University of California Press. Jones, D. J.; Forehand, R.; & Beach, S. R. H. (2000). “Maternal and paternal parenting during adolescence: Forecasting early adult psychosocial adjustment”. Adolescence, 35(139), 513–530. Simons, L. G.; & Conger, R. D. (2007). “Linking mother-father differences in parenting to a typology of family parenting styles and adolescent outcomes”. Simons, R. L.; Simons, L. G.; Burt, C. H.; Brody, G. H.; & Cutrona , C. (2005). “Collective efficacy, authoritative parenting and delinquency: A longitudinal test of a model integrating community- and family-level processes”. Criminology: An Interdisciplinary Journal, 43(4), 989–1029. Baumrid, D. (1967). “Child come practice anteceding three patterns of pre school behaviour”. genetic psy monographs, 75 43 88. Baumrid, D. (1991). “The influence of parenting style on adolescent”. 11, 11, 56-95. Maccoby, E. E. & Martin, j. A. (1983). “Socialization in the context of the family : Parent-child interaction”. In P. H. Mussen & E. M. Hether, hand book of child psychology: Vol.4. Socialization, personality, and social development (4th ed), new york, wiley. Maccoby, E. E. (1992). “The role of parents in the socialization of children: An historical, overview developmental psychology”. 28,1006-1017. Bandura, A. (1989). “Social cognitive theory”. In Vasta, R. (ed.), Annals of Child Development, JAI, Greenwich, CT, pp. 1–60.
77 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 GERIATRIC PROBLEMS OF ADJUSTMENT A.Anjum* Laxmi Rani** Abstract This study was conducted to find out the adjustment problems in old age. It was found that the obtained’ t’ value is 0.51 at 98 degree of freedom and .05 level of significance, which is less than the above value, which shows that the groups have poor adjustment whether they are living with their families or in Ashrams. They are having worries and tensions and uncertainties of life which make their adjustment unsatisfactory. Key words: Gerontology, Geriatric, Adjustment, Mental health & Counselling: Introduction Gerontology is the study of the process of aging, across the life span, whose multi- disciplinary aspects include physical, mental, social and spiritual changes in people as they age. Old age is defined as the age of retirement that is60 years and above. Improvement in health care technology has resulted in increased life expectancy. In India the elderly peopleconstitute around17% of the total population which is supposed to increase more in future. Theproblems of elderly people are mainly related to their mental stress, physical incapability and neglect of the offspring. Several studies revealed that a large number of octogenarians felt themselves neglected and uncared for in the family. According to National Sample Survey Organization, 36.7% of 70 Million old age people want to shift to old homes because they can’t manage alone. Saraswati (1976) concluded in his study that the old age has started emerging as a social problem in the Indian Society due to the sociocultural changes brought about by Indus trial revolution. The past recognition of old man or woman in the family, neighbourhood and community as mentor has been reduced to great extent in modern Indian life and therefore old man or woman perceives low social worth or self- esteem. In certain families elderly person need health care, financial assistance, social recognition, counsellingservices to copewith stress for overcoming ‘death anxiety’, ‘sense of isolation’, ‘feeling of social deprivation due to negligence’, ‘feeling ofdisability and dependency’, ‘low social esteem and lethargichabits.’ Keeping in view, the Psychologists found theadjustment problems of old persons which have takenplace with time. According to Shaffer, L.S. “Adjustment is the process by which living organism maintains a balance between his needs and the circumstances that influence the satisfactions of these needs.” In the words of Coleman, James C., “Adjustment is the outcome of the individual’s attempts to deal with the stress and meet his needs: also his efforts to maintain harmonious relationships.” “Adjustment” can be defined as a process of altering one’s behaviour to reach a harmonious relationship with their environment. This is typically a response brought about by some type of * Professor of Psychology (Retd). BRA. Bihar University, Muzaffarpur. * Associate Professor, Psychology, MSKB. College,BRA. BU. Muzaffarpur. 78 Anjum & Rani / Geriatric Problems of Adjustment change that has taken place. The stress of this change causes one to try to reach a new type of balance or homeostasis between the individual (both inwardly and outwardly), and with their environment. Mental health is an index which shows the extent to which the person has been able to meet his environmental demands-social, emotional or physical. However, when he finds himself trapped in a situation where he does not have matching coping strategies to deal with it effectively, he gets himself mentally strained. This mental strain is generally reflected in symptoms like anxiety, tension, restlessness or hopelessness among others. If it is felt for too long and too extensively by the person, these symptoms may take a definite form. Mental health, as such, represents a psychic condition which is characterized by mental peace, harmony and content. It is identified by the absence of disabling and debilitating symptoms, both psychic and somatic in the person. The present study is to investigate the adjustment problems of old persons living with their families and in old age homes/ Ashrams. Materials &Methods 1. Sample - This study was conducted to find out the adjustment problems of elderly people. For this verypurpose a sample of 100 old persons was selected randomly from old age homes and community. 50 old persons residing in old age homes& 50 living with their families. 2. Questionnaire - The old age adjustment inventory developed and standardized by Hussain S. &Kaur(1995) was administered to find out adjustment problems of the aged people. The inventory measures the adjustment problems in areas of home, heath, financial, marital, social and emotional. Out of them three areas marital, social and emotional aspect was taken for this study. Marital area dealt with the questionslike - Attraction for marital relationship, feeling life incomplete without marital relationship, dependency on life partner, affection for each other, seeking opinion from each other, importance for physical attraction etc. Social area dealt with the questions like- feeling secure with people, feeling happy when people come to meet, like to live alone, taking interest in children etc. Likewise emotional area dealt with the questions & views of oldpersons as old age is emotionless age, feeling to commit suicide, anxiety about self-respect, anxiety about disease, feeling of fear, feeling of dissatisfaction for life etc. Statistical Analysis - Comparison was made between two groups and results were analysed by using Mean, S.D. & ‘t’test, as statistical tools. Results & Discussion: Marital Adjustment of Old People Group Size of sample N = 100, Old people living with their families 50,Mean= 12.6 S.D=1.55
79 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Old people living inAshrams. 50, Mean= 12.4 S.D = 2.24 t. value=.51 .05 level of significance Results revealeda very slight difference in the family adjustment of elderly people. Mean value for family adjustment is 12.6 and 12.4 & SD 1.55 and 2.24 respectivelywhich showed that there was no significant difference in family adjustment for people living with their families andliving in Ashrams. The obtained’ t’ value is 0.51 at 98degree of freedom and .05 level of significance, which is less than the above value, which shows that both the groups share poor adjustment whether they are living with their families or in Ashrams. In the present timeselderly people aremore depressed and sad in the materialistic world. They arehaving worries and tensions and uncertainties in life whichmake their adjustment unsatisfactory. Social adjustment of Old People: N = 100 1. Old people living with their families= 50, Mean 19.00, S.D=1.40 2. Old people living in Ashrams = 50, Mean 15.92, S.D=2.65 t value7.24 The analysis of data revealed that the elderly people who were living in Ashrams felt more social adjustment problemsthan those who were living with their families. Mean value forsocial adjustment is 19.00 & 15.9 S.D. 1.40 & 2.65 for oldpeople living with their families and in Ashrams respectivelywhich showed significant difference in social adjustmentof both the groups. The obtained‘t’ value is 7.24at 98 degree of freedom & .05 level of significance which ishigher than the table value which confirms that old personsliving with their family members are socially well adjustedand have lesser social adjustment problems as comparedto the old people living in Ashrams. Emotional Adjustment of Old PeopleN=100 1. Old people living with their families = 50, Mean=17.1, S.D.=2.62 2. Old people living in Ashrams = 50, Mean=15.8 S.D.=2.68 ‘t’2.43 The above results showed a significant difference in emotionaladjustment of older people. Old people living in Ashrams feel more emotional problems than those who areliving with their own families. The calculated‘t’ value is greater than table value at 98 D.F. which showssignificant difference in their emotional adjustment. Studieshave proved that ‘elderly people are more sad and depressed in the ‘materialistic culture’ and a feeling of insecurity is more due tolack of moral support from children which increasedemotional disturbances. They are mentally and emotionallystressed and have tensions and worries due to growing uncertainties. It was also revealed that the problems like loneliness, isolation and neglect are facedby the elderly people in today’s society. References Agnihotri, H.K. (1976). “Problems of the old age”. Journal of Psychological researches, 22, 1. Ananthraman, R.N. (1983). “Concept of self among elderly”. Indian Psychological abstracts No. 304, 20, 2, PP 47-51.
80 Anjum & Rani / Geriatric Problems of Adjustment
Coleman, J.C. (1960). “Personality Dynamics and Effective Behaviour”. Chicag. Scott. Foreman and Comp. p.5. Dutta Ella, (1989). “Growing old in young India”. Sunday review ‘The times of India’ Sept. 17Lug Y.C. - Home discipline and reaction to authority in relation to marital rules. Marriage family living 15, 223- 225, 1953. Nayar, P.K.B. (1987). “Ageing & Society”. Social Welfare, 34, 28-31. Ram Murti, P.V. (1962). “An adjustment Inventory for older people”. Journal of psychological researches, VII (3). Saraswati, H. (1976). “The changing relationships between young and the old”. Journal Social welfare, 24, 29-32. Sharma, P.S. (1980). “Treat them with dignity and love”. Journal of Social Welfare, 26, 2-10. Saha, G.B. (1984). “Some Social psychological aspects of aged”. Indian psychological Abstracts No. (316) Vol. I No. 21. Shaffer, L.S. (1995). Shamshad Hussain, Dr. Jasbir Kaur, Old age adjustment Inventory.
81 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 AGING: ADVANTAGES, ISSUES AND CHALLENGES Irina L. Pervova* The current world in general is an aging society with technological progress, increasing life expectancy and active life period of population. Factors contributing to this increased longevity may include: better nutrition, reduction in smoking and alcoholism, less environmental pollution, and enhancement of personal life styles with priority for improved psychological stimulation and social inclusion. Western Europe and Japan are characterised by the highest level of demographic ageing (25-32%), but in Eastern Europe the population aging is also in progress (13-15%), (World Bank, 2015). The demographics of aging are common to all developed countries; with accompanying issues and problems in economic, medical, social, psychological and ethical areas, effective on a world-wide basis. The image of an elderly person has been transformed throughout history all over the world. On the one hand old individual is seen as a wise, experienced and respectable person and on the other – as weak and dependent as a child. Aging is an ambivalent condition: there are obvious physiological (health systems, reactions timing etc.) and psychological changes (memory decrease, self-esteem lowering, loneliness, approaching death experience, etc.) in older age; at the same time after finishing career for an aged person there appears time for dreamed things to do, for being helpful to children and grandchildren, community and society, for the whole planet. A race for youth and the construction of old age importance as one of the key dichotomies of the modern society is as old as the world. The artifices of women of the ancient world to support their body youth are weaved from legends; and Ciceronian treatise “On Old Age” in which he defends the positive attitude to life in old age and the possibility of happiness and well-being is still relevant. Changing the timing of the silver age cohorts in connection with the scientific, technological, social achievements, require re-examination of traditional concepts and definitions of these cohorts. The previous 60-year-old move to the 80-year-old and present-day 60-year-old – to a former 40-year-old, which pushes the threshold of old age. Changing the timing of the silver age cohorts pushed the threshold of old age. Expectancies for life-long learning, with appropriate adaptations (mental and physical) should be associated with a priority for positive self-image development, active life position, with active enhancement of personal life style, e.g. physical activities, positive psychological stimulation, and group interactions. Psychological support and social inclusion are important issues in aging, which can be ensured by the family and/or community. The concept of “active aging” provides the basis for improving the quality of life for increasing aged populations; with an increased priority for community-based supported (assisted) living over the regimented environments typical of most congregate institutional residences (nursing homes) as the primary service option. In some countries the health, beauty and entertainment industries have recognized the market potential of this group and oriented their services and goods to this segment of the population, particularly since their financial condition is more favorable for exploitation. Material
* Prof in Psychology and Sociology, Saint-Petersburg State University, Russia .e mail : [email protected] 82 Pervova / Aging: Advantages, Issues and Challenges production and services are rearranging according to the needs of the elderly. The modern concepts of successful aging are based on human activity theory and mainly concentrated around three areas: safe aging as the end result (absence of diseases, a high level of cognitive, physical and social activity), compensatory processes (goals and interests importance, compensation of reduced or lost function) and proactivity (coping strategies). The concept of “active aging” provides the basis for improving the quality of life whether in independent, assisted living situations or in full support institutional residences. The reality of an active lifestyle importance in silver age from the medical point of view can be seen in the works of a large number of authors (Aisa et al, 2014, 2015; Erzin 2014; Fereshtehnejad & Lokk, 2014; Lattore et al, 2015; Lin et al, 2014; Perales et . al, 2014, Sharipov, Dzhaynakbaev 2014, etc.). Efforts to include the increasing segments of the general population into the social structures involve multiple variables beyond the economic spheres. The increased load on the working population and attempts to build in elderly into the structure of society relate to specific non-economic aspects of demographic aging (Levinson, 2011; Rogozin 2012; Shmerlina 2013). There is an apparent dichotomy between the cultural emphasis on youth and recognition of the dignity and respect due the aged populations. Social, technological, and scientific advances have progressively shifted to the definitions of and expectations for aged people to later years of life. Nevertheless there is another reality in modern societies such as ageism in a form of elderly discrimination, which is still a shame of the modern world and limits life opportunities, occupational and recreational options and the psychological comfort of aged people. Ageism is not a rare phenomenon especially in youngsters; it leads to isolation, loneliness and exclusion of aged of society. The concept of ‘social exclusion’ for elderly is based on ageism causing segregation, disparagement, gerontolization of poverty etc.) and its implications in civil rights. It depends on society and individual what particular elderly roles prevail in society and what political, social and cultural rights the aged category of people has. Physical and mental activity (Levine, 2016; Milligan et al, 2015), motivation for self-integrity (Ericson, 1996), and optimism (Singh, Shukla, 2014; Svoboda, 2015) are the motor (key ingredients) for successful aging in any country. Russia, like many countries of the world, is an aging society. Increasing life expectancy, coupled with lowered birth rates (up to 2013) resulted in a higher percentage of aged persons in the general population. The percentage of aged persons in Russia is generally equivalent to that, characterizing European countries. The life expectancy for Russians is 70.9, for males it is 65.3, for females – 75.5 years (Rosstat, 2016). Coincidently, it is only 5 years more, than the retirement age for Russian males. The retirement ages for females (55 years) and males (60 years) are prime determinants of the scale of service needs for elderly persons. There are 10% more females than males at age 60. The family has been the major provider of care and support for aged in Russia. Traditionally this care and support has been available via multi-generational family structures and relationships. Many general factors and influences have affected the status of needs and services.
83 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
The positive utilization of free or leisure post-retirement life phases is a major concern in all countries. Failure to provide support in these areas may result in significant problems in psychological and social arenas. Employment of older persons on a full or part-time remunerative basis has to be a priority for the Russian labor market. This paid employment must also be coordinated with volunteer programs to support social and personal stimulation for aged cohort of population. Russian elderly form a substantial part of country’s political electorate. T. Marshall (1965) noted that social rights are more familiar and important for citizens than political ones. Are politics interesting for Russian elderly? Can an individual voice be influential in elections? What place does education play in people’s life? How are elderly satisfied by social care? These and other information to get was built into the survey held in Saint-Petersburg, Russia in May 2016. The research was held by phone (CATI system) - random sample, 450 respondents of 60 and older (E) and 530 of 18-29 years old (Y). The research methodology in a study to answer these questions focused on structured phone interviews (CATI system; Saint- Petersburg, provided by Resource center of Saint-Petersburg State University) with random sample subject group of 450 respondents of 60 and older (E) and 530 of 18-29 years old (Y) (43% male, 57% female). About half of elderly respondents couldn’t name any of political rights (E-45%, Y-35.5%), and at the same time the majority (E-81.4%, Y-64.1%) were checking political news via mass media on the daily bases. Nevertheless the suffrage was named as the main political right by a half, or close to half of the sample (E-42.2%, Y-50.4%). There were also named the freedom of thought (E-12.8%, Y-20.3%); the right to freely look for and disseminate information legally (E-11.6%, Y-8.5%); the right to assemble peacefully and without weapons, hold rallies, meetings, demonstrations and pickets (E-8.5%, Y-5.9%). However social rights seem to be more familiar to elderly citizens than political ones, such as the right for labour (E-33.7%, Y-28.4%), education (E-33.7%, Y-47.0%), medical help (E- 42.6%, Y-40.3%), and social care (E-33.7%, Y-17.8%). The majority of respondents (E-62.0%, Y-78.0%) consider social rights to be more important for them than political ones; some (E- 21.7%, Y-8.9%) consider equality of both and the least part (E-9.1%, Y-6.4%) prefers political rights. Thus elderly population knows more about political and social rights than youth besides education and in case of difficult life situation would rely on themselves or a family rather then apply to social services (E-51.2%, Y-47.0%). To make elderly active, helping the family and socializing will avoid exclusion, break psychological barriers and delay aging. The knowledge of social rights, as well as where and how to apply for assistance, may reduce social exclusion and t difficulties in adaptation to the circumstances and objectives of aging.
84 THOUGHT PROCESS RE-ENGINEERING (TPR): A TOOL FOR CBT Sajeev Nair* Abstract
Everyday life is full of decisions and decision making style (DMS) of the individual .DMS is considered to be the building block of all our achievements. What we were, what we are and what we will be, all are the outcome of our decisions. So the science behind each decision needs exploration. The following questions thus come to mind : why people differ in their decisions ? what is the Neuro exploration & Neuro-management of decision making perspectives of the organism ? is there any effect of psycho-social or socio-cultural components in decision making style ? And many more questions like thisAll depends on our thought process. This paper is an attempt to discuss about how this thought process engineering is influencing our behaviour and also its role as a tool to cognitive behavioural therapy.
Key Words : TPR, CBT, DMS,ACC, TPR®, Introduction Cognitive-behavioral therapies (CBT) are short-term, collaborative, problemfocused therapeutic methods aimed at reducing symptoms and improving the quality of life of people with emotional disorders. Due to having been rigorously tested, CBT is now considered an empirically- supported treatment for a variety of disorders, such as anxiety disorders, mood disorders, learning difficulties, sexual problems etc. In the present world emotional disorders are quite common amongst the elderly; especially when they feel that they are left alone by their children. Cognitive-behavioral therapies combine two different theoretical and therapeutic approaches resulting from two different, but complementary paradigms of human nature and psychopathology. One is the behavioral paradigm, based on the learning theory and models of experimental psychology. Its basic idea is that every behavior, either adaptive or maladaptive, has been learned. The other is the cognitive paradigm, which claims that mental disorders arise from altered cognitive processes, i.e., specific errors in information processing. Thought Process Re-engineering. (TPR®) is a scientific process that helps people see the relationship between beliefs, thoughts, and feelings, and subsequent behavior patterns and actions. Through R, people learn that their perceptions directly influence their responses to specific situations. In other words, a person’s thought process informs his or her behaviors and actions. Thought Process Re-engineering. (TPR®) is grounded in the belief that it is a person’s perception of events.rather than the events themselves.that determines how he or she will feel and act. For example, if a person with anxiety strongly believes that ‘geverything will turn out badly today, then these negative thoughts may influence him or her to focus only on the perceived negative things that may happen while blocking out or completely avoiding thoughts or actions that may disprove that negative belief system. Afterward, when nothing appears to go right in the day, the person may feel even more anxious than before, the negative belief system may be strengthened, and the person is at risk of being trapped in a vicious, continuous cycle of negativity and anxiety.
* Behavioural Scientist, The pioneer of TPR, www.sajeevnair.com 85 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
TPR® is developed with the belief that by adjusting our thoughts, we can directly influence our emotions and behavior. This adjustment process is referred to as Thought Process Re- engineering. Life-Long Learning The basic CBT hypothesis is that people can continue to learn throughout their lives, even at old ages. Both functional and dysfunctional behavior is learned. Every behavior that is learned may be unlearned and replaced by other behavior that is more functional. CBT helps people to learn and adopt new knowledge and skills, which will enable them to observe and change their own thoughts, behavior, and emotional states. After a successful therapy, patients may be expected to be more functional and have better subjective quality of life. Do these changes in behavior and attitude have a neurobiological basis? In the 1970s, the adult brain was considered to be a strictly organized and fixed structure, with different brain regions responsible for different functions. However, this perspective has changed in the last 30 years. Research has shown that cortical networks in the brain change, including synaptogenesis, neurogenesis, and programmed cell death, as a result of one’s experience. The brain is characterized by neuroplasticity, or cortical remapping, which is a complex, multifaceted, and fundamental property of the living brain that allows it to adjust to the changes in environmental and physiological conditions and experience. Individual connections within the brain are constantly being removed or recreated, which largely depends upon how they are used. One of the key elements of the human brain’s ability to change through neuroplasticity is creation of interconnections between neurons based on their simultaneous firing over a period of time. This concept is captured in the aphorism, "neurons that fire together, wire together"/"neurons that fire apart, wire apart", which was articulated in more detail by Canadian psychologist Donald Hebb. Long-term synaptic plasticity is believed to be the molecular basis of learning and memory (Clark & Beck, 2010; Kandel, 1998). It has also been established that learning accompanied by the development of new neuronal connections also leads to the development of new neurons. Neuroplasticity leads to the fact that even at old ages human brain has the ability to create new neurons and that the neurons have the ability to create new synaptic connections. This when engineered properly using TPR® techniques, new learning and new memories could be created even at old age. Cognitive Regulation of Emotions and Behavior There is evidence that a chronic inability to self-regulate negative emotions, such as sadness and fear, may play a pivotal role in the genesis of clinical depression, anxiety disorders, and other mental disorders (Davidson, Putnam, & Larson, 2000; Jackson, Malmstadt, Larson, & Davidson, 2000). This is more in the case of elderly. According to TPR®, emotional reaction and behavior depend on cognitive processing in a specific situation. Each individual receives and processes data from the environment in his or her particular and unique way. In accordance with the perceived information, interpretation of its importance, understanding of causative relationships, and personal meaning ascribed to an event, an emotional reaction arises and influences the behavior. It means that the event itself has no "objective" meaning, but is perceived, interpreted, remembered, and evaluated in relation to oneself, in accordance with one’s own cognitive activity. However, a person cannot respond to all pieces of information received. Information has to be filtered. For something to be perceived at all, it has to be personally important, and this importance is based on previous experiences, i.e., memory. The perceptioncognition- emotion sequence starts by paying attention to some internal and/or external stimulus, followed by assessment and emotional and behavioral reactions. Emotional response to a stimulus may be automatic (especially in case 86 Nair / Thought Process re-engineering (TPR): A tool for CBT of threatening and dangerous events, when the process follows a perceptionemotion - cognition sequence), but for most stimuli, a volitional cognitive evaluation is needed in order to develop an emotional reaction. Is there neuro-scientific evidence of the basic hypothesis that change in the cognitive activity results in the change of emotional dimension? From a neurobiological perspective, different regions of the brain are involved in emotion regulation processes. Generation and regulation of emotions involves interplay between two modes of information processing: automatic, reflexive, bottom-up and effortful, symbolic, and top-down processes (Clark & Beck, 2010; Wright et al., 2008). Bottom-up processing is a primitive, automatic, effortless, implicit, and nonconscious information processing dominated by the salient features of a relevant stimulus or situational cues and their schematic associations. Studies of emotional evaluation using ‘MRI have associated bottom-up processing with the amygdala. Traditionally, it was considered that bottom-up activity was automatic and not modulated by cortical structures. Top-down processing is slow, deliberate, explicit, and strategic form of rational processing that uses rule-based knowledge to guide the information processing system. A region frequently implicated in top-down processing of emotion is the orbitofrontal cortex (OFC). Other regions implicated in top-down processing include the ventromedial prefrontal cortex (vmPFC) and anterior cingulate cortex (ACC) (Lane, Fink, Chau, & Dolan, 1997; Ochsner et al., 2004; Taylor, Phan, Decker, & Liberzon, 2003). Subcortical emotion generating structures and cortical emotion regulating structures interact in complex ways that result in behaviors that are indicative of the regulation of emotion (Ochsner & Gross, 2007). Thought Process Re-engineering is a basic technique used to replace a dysfunctional manner of thinking by a functional one. From neurobiological perspective, it is the top-down regulation by which rational thinking leads to reduced emotional response and regulation of negative emotional states. This approach is really helpful for the elderly when executed properly. TPR® - Think what you Think Self-directedness on one’s own body and mental activity, interpretation of what is observed, and the resulting emotional reactions may be either functional or non- functional. Individuals with emotional disorders have mistaken beliefs and wrong knowledge about their own thoughts and thinking processes, they are over- concerned with them, and often experience these thoughts and emotions as a reality that caused unwanted emotional reactions in them. By changing dysfunctional thinking using TPRR, we can achieve the desired changes in the behavior and emotional response. TPRR was focused on producing changes in the thinking content and, consequently, in other aspects of functioning. TPR® often suggests conscious or volitional control of thoughts, memories, and actions. This involves attention, conflict resolution, error correction, inhibitory control, and emotional regulation. These aspects of TPR® are presumed to be mediated by a neural circuit involving mid-frontal brain regions. In order to influence this aspect of thinking, TPR® has successfully developed techniques directed at observing, exploring, and changing one’s own thoughts and emotions. A person is taught not to accept his/her thoughts and emotions as accurate reflections of reality, but as short- term, transitory mental events. An awareness of awareness itself allows the individual to consciously attend to thoughts, emotions, and action tendencies and to choose those that benefit the individual. TPR® involves a systematic retraining of awareness and non-reactivity, enabling the person to consciously choose adequate thoughts, emotions, and sensations rather than habitually reacting to them. 87 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 CRITICAL ISSUES OF TEACHER EDUCATION: PROBLEMS AND ACHIEVEMENTS MD. Osama* Abstract This study deals with Challenges and Opportunity in Teacher Education. From the primitive age to the modern Information Communication Technology based society transmission of knowledge and skilled are trough teachers. Technology never replaces the teacher only for that the effective domain of the human being can not controlled by the machine. Economy, In view of the tremendous pressure on total educational knowledge enterprise for higher and professional education in particular, privatization is not an option but a natural evolution. The earlier system, where the state and charitable institutions come forward to open new professional colleges, is obviously unable to cope with the rising demands of a high profile professional education. The infrastructural, managerial and financial requirements coupledwith a high yielding entrepreneurship has made the private sector to take a direct plunge into the educational enterprise, may be the process is still in its infancy. Hence there is a Need and Importance of Commercialization of Teacher Education Key Words : Challenges of TE, needs of TE, Quality of TE Introduction The fourth wave of education is based on the philosophy of knowledge and Information Communication Technology(ICT). Today in the era of 21st century educational institutes become a knowledge enterprise that has to operate rapidly changing environment of globalization of trade. In our country, India due to global revolution in information technology and conflicting demands of industry and institutions growing the rates of unemployment. Now we have need of global market for higher educational and good quality Universities and colleges’ institutions to develop our country and to produce quality teacher in the field of education. The changes in global environment thus open up challenges of globalization of economy, society and knowledge demand from higher education in the team of quality and quantity both. Today’s situation is going on because of high ambitions of parents, guardians, students similarities, comparison for high status, young boys and girls are also going more sophisticated. Man power requires meals of the changing power trends. These dramatic challenges are serious questions for teacher education and particularly any professional education urging educational planner to rethink over it. Universities, National Institutes and Research Institutes are working specially in India for solving social problems and new way for living. Recent study was made and it was found that Four Indian education institutions figure in the latest world university rankings, which continue to be topped by the universities of Harvard, Cambridge and Oxford, for their strengths in teaching and research. The four Indian institutions are the Indian Institutes of Technology (IITs), the Indian Institutes of Management (IIMs), the Jawaharlal Nehru University (JNU) and Delhi University (DU). The IITs ranked 57th in the world’s top 200 universities list and the IIMs ranked 68th. The JNU came 183rd in the list. The Times Higher Education Supplement, an authoritative journal in academia, announced the third edition of the rankings.
*Asst.Prof., LN Mishra College of Business Management,Teacher Education Programme,Muzaffarpur,BIHAR,INDA 88 Osama / Critical Issues of Teacher Education In the list of the world’s top 100 science universities, IITs ranked 33rd, while in the list for top technology universities, the rank of IITs jumps to the third place after the Massachusetts Institute of Technology (MIT) and the University of California, Berkeley. Teacher Education, Training and Research institutions like National Council for Educational Research and Training (NCERT), National Council of Teacher Education(NCTE), Rehabilitation Council of India(RCI) are independent body working under the umbrella of Human Resource Development (HRD) Government of India for the development of Educational system, training and extension activities. Higher education is based upon three pillars i.e. teaching research and extension activities. In the field of teaching it is totally depends upon the teaching technology and how to access the teaching learning principles. Due to lack of quality research activities in higher education the position of the any country in the globalization always lagging behind. Research helps to refine knowledge, skill and understanding of any concept, theory, postulate or phenomenon. In social sciences it is difficult to understand the activities of any human being but in real phenomena laboratory research the findings are acceptable worldwide. Need and Importance of Teacher Education: In each and every year, approximately 19 million students are enrolled in high schools and 10 million students in pre-graduate degree courses across India. Moreover, 2.1 million graduates and 0.3 million post-graduates pass out of India’s non-engineering colleges. Within the National frame work of educational system NCERT has framed different teachers training Programme for physical education and education in special at elementary level to higher education. Government of India has adopted policy Education For All(EFA) irrespective of any containments physically, economically or socially. According to the report of Government of India on one state still able to achieve cent percent of literacy among their people. For achieving the objective, there is need of skilled and trained teachers in different sectors of the society. Challenges and Opportunity in Teacher Education From the primitive age to the modern Information Communication Technology based society transmission of knowledge and skilled are trough teachers. Technology never replaces the teacher only for that the effective domain of the human being can not controlled by the machine. Economy, In view of the tremendous pressure on total educational knowledge enterprise for higher and professional education in particular, privatization is not an option but a natural evolution. The earlier system, where the state and charitable institutions come forward to open new professional colleges, is obviously unable to cope with the rising demands of a high profile professional education. The infrastructural, managerial and financial requirements coupled with a high yielding entrepreneurship has made the private sector to take a direct plunge into the educational enterprise, may be the process is still in its infancy. However, a tremendous beginning has already been made and the forces of demand and supply will sooner or later bring the required semblance to the system. A look at the possible contribution, that privatization can make to higher education enterprise as a whole, may generate a lot of hope for the future of higher and professional education. However, a closer look, at ‘what is’ as different from ‘what should be’, spells doom – the future of higher education seems bleak. Let me share with 89 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 you some of the major concerns of defective and/or ineffective privatization in higher education, teacher education and other professional courses such as adverse effects on quality of education, withdrawal of government and increasing commercialization in higher education. Need and Importance of Commercialization of Teacher Education Commercialization in teacher education pertaining situation on high ambitions of parents, guardians, student’s similarities, and comparison for high status. Young boys and girls are going more sophisticated now days in getting professional degree as soon as early possible. A look at the possible contribution, that privatization can make to higher education enterprise as a whole, may generate a lot of hope for the future of higher and professional education. However, a closer look Good Teaching requires four types of knowledge and skills. Some special needs are required to stop commercialization and to increase the quality of teachers. This prompts that many agencies are affiliated with this situation and field .They should take action. It is our duty towards nation to promote good quality teachers to put India in the raw of well developed countries. Therefore, in this context, community welfare societies, NGOs, voluntary organizations, religious trusts can be encouraged to come forward to successfully run teacher education institutions without indulging in commercialization. When graduate or postgraduate students establish him/herself for the degree of teacher, he/she should know the ethics of teacher education and after the completion of training when he/she apply the methodology in the classroom and strictly follow to generate qualified students is called quality of teacher, and they should manage and perform the quality. There has been a phenomenal expansion of higher education in general and teacher education in particular during the post-independence period, so some suggestions and information may require controlling today’s situation of education field. It is desirable to control commercialization to produce qualified teacher. Fast Diversion towards commercialization in higher education Social compulsions: Individuals wish to get name and fame in the society. Some persons contribute to the social cause – human welfare including education and health. Philanthropists have set up educational institutions may be without any commercial motive. But this is also now getting vitiated by financial gains even through social welfare ventures. Commercialization has taken over the earlier social service motivation to money making motive. Political opportunism: Some of our law makers are also motivated to enter in this area which they feel would not only lead to more financial gains but also stability in their own careers. Psychological attitude: Some individuals develop strong positive attitude towards gainful economic activities. They have urged to earn huge wealth and assets. This money oriented life style drives people to engage in commercialization in their respective field of work. Culture of corruption: In the very recent years, there have been several quick changes in our cultural outlook. Social responsibility towards society has deteriorated and surrendered itself to profit earning only. The other cultural changes include trends such as - sacrifice to selfishness, social welfare to personal gains, fair means to any means, and ethical behavior to apathy and moral values to no morality.
90 Osama / Critical Issues of Teacher Education Economic value: Among all the human values in the materialistic world of today, the economic value is becoming predominant in one’s life. This drives an individual or a group of individuals into entrepreneurship and activities that would excel others in pursuit of economic achievements. It is not limited to trade/business sector; it has also entered into other social welfare sectors such as health, education, etc. The economic value naturally leads to commercialization Commercialization in Teacher Education: There has been a phenomenal expansion of higher education in general and teacher education in particular during the post-independence period, so much so that during the last decade, government found it difficult to finance the setting up of new colleges. Therefore, universities and colleges are being encouraged to start new courses generating their own resources, thus ushering in an era of self-financing schemes for starting useful and professional courses in teacher education which have gained special momentum today. Most of the operating revenues for self-financing courses and institutions come mainly form tuition and other types of fee. Now-a-days these institutions are coming up in large numbers and B.Ed. courses is becoming more popular because of the focus on universalisation of elementary education, education for all, and right to education which will promote job opportunities for teachers. There is a danger that the self financing colleges may attract students having less ability but more pay ability. Some educational thinkers oppose the self-financing aspect of teacher education because of the chances of ills of commercialization and corruption creeping into this system. There are reports about the deteriorating quality of education in some of the privately run institutions which is alarming. It is not only adopted by the private colleges all over India facilitating teachers training programme at elementary level to higher education as a course Diploma in Education(D.Ed.), Bachelor of Education(B.Ed.) and Master of Education(M.Ed.) through self-financing programme but most of the University who have not even Department/school of education started teacher training programme as a source of earning. The in-competent teachers even have not gone through basic teachers training become the Dean of the courses and promoting corrupting for sustainability of position. The decision making power of the person are not from the discipline and making decision with the direction of other. NCTE the apex body made by parliamentary act for promoting and quality control of the teachers training programme become inactive due to interference of political power and intervention of non-qualified officers. Quality of Teacher Education through Self Finance Scheme (SFS): We would like to end by clarifying a few misconceptions. One of the mistakes of the new globalization ethos is to reduce all human practices to commercial transactions, but also to assume that it is through commercial transactions alone that technology is shared and produced. Yet History does not support this view. Since the first university was founded in Bologna in the 11th century, scholars around the world have shared their understanding of nature and the human condition without the goal of profit. Furthermore, it is only a recent phenomenon that we would conflate ‘education’ with the technical means to promulgate it. To equate education with technology is to miss the point entirely. As professor Noble writes, Education is a 91 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 human relationship. It is a process that necessarily entails an interpersonal relationship between people that aims at individual and collective knowledge. Whenever people recall their educational experiences, they tend to remember, above all. Not courses or subjects or the information imparted, but people, people who changed their minds or their lives, people who made a difference in their developing sense of themselves. It is a sign of the current confusion about education that we must be reminded of this obvious fact: that the relationship between people is central to the educational experience. Education is a process of becoming for all parties, based upon mutual recognition and validation and centering upon the formation and evolution of identity. The actual content of the educational experience is defined by this relationship between people and the chief determinant of quality education is the establishment and enrichment of this relationship. We cannot dispute that there are potential benefits to ‘online’ learning. However, they cannot possibly replace the benefits ‘offline’ learning. Until the provinces and federal government commit to more public funding to hire more people — faculty members, teaching assistants, administrative support staff and maintenance staff — the quality and accessibility of education will not improve, regardless of the latest technological discoveries. Present scenario of Education Colleges: Good Teachers produce a good student that is the primary purpose of teaching and the basis up on which teachers should be evaluated. The debate over content versus teaching skills creates and inappropriate dichotomy a false choice. Good Teaching requires four types of knowledge and skills; Basic academic skills; Through context knowledge of each subject to be taught; Knowledge of both generic context basic pedagogy; Hands on teaching skills; Teaching continuum tells to the educators that teacher’s role is to educate people in each and every way with the help of agencies. They should think about the quality not the quantity. When ever we act many eyes are performing our evaluation. Spectrum of Commercialization: Information based on personal communication in confidence with the stakeholders – parents, teachers and students reveals that the malpractices of commercialization cover a wide spectrum. These include the following: Auctioning of NRI seats; Charging penalty fee for absenteeism; Pricing high the publications – prospectus, magazines; Charging registration and admission fee extra; Getting donations on ‘as you please’ basis; selling of payment seats; Charging hostel and mess fee higher than market rates; Extra charging for admission forms and Brochures; Fluctuation in the fees and hospitality. The stakeholders: The stake holders who are victims of commercialization in teacher education need to change their attitude and outlook. This would go a long way in curbing the commercialization. 1. In years to come the prospective employers will substantially increase in the private sector because the government is suffering from financial crunch. The employers’ worry is about the quality of training and the competency of the teachers coming out of these institutions. They would employ those teachers who have the skill and competency to perform well in the school system. Non-performers will not be allowed to continue unlike government schools only on the basis of degree in education.
92 Osama / Critical Issues of Teacher Education 2. Students are the main stake holders. Those who are desperately seeking admission to B.Ed. are ready to bear the burnt of commercialization and even corruption. The students will have to stand against the malpractices of institutions, if they find that they are not getting the worth the money being paid. This would be self-forcing the curb on commercialization. 3. Parents – mostly guardians/parents of the girls are found willing to pay “premium” to seek a seat in an institution even without bothering much about the quality. They want their wards to get the B.Ed. degree for latter matrimonial prospects and future security against bad times. They have to overcome such compulsions for the sake of better quality training in reputed institutions and ensure better placement chances. 4. Owners of SFIs invest huge amount of money on building and other infrastructural facilities. Recovery of investment is slow as per the revenues. Long term recognition by NCTE and affiliation by university are uncertain in many cases. This prompts the owners to recover the investment as early as possible. Some of the owners resort to commercialization at the cost of institutional reputation and training effectiveness. 5. Teachers working in many SFI’s are being underpaid. Some are terminated at the end of the session. Thus there is always uncertainty in the career. Role of Agencies: Commercialization of teacher education is malice. Being an ingredient of self financing education in developing countries, it cannot be totally eliminated. Though it can be minimized and curbed to some extent. Therefore, some suitable bold measures will have to be taken to curb the commercialization in teacher education. Hence, there is cruciality of the roles of NCTE, NAAC, affiliating universities and the concerned state governments and the need for immediate implementation of the measures. (A) NCTE with Watch Dog Panel: HRD may set up a panel of eminent teachers and education experts to monitor the appointment of inspectors who would inspect the colleges of teacher education for recognition. Since complaints have been received against some of the inspecting teams giving a clear picture about the institutions visited the panel would also examine the process to grant of recognition to private self financing colleges of education by NCTE. (B) State Level Manpower Planning in Teacher Education: Regular surveys have to be undertaken by the state planning department to ascertain the manpower requirements of teachers in various subjects at different levels in the state. Based on this data, the need for opening new teacher education institutions or offering new courses in the existing institutions should be the decisive criteria for issuing ‘No Objection Certificate” to an individual or a society/trust. (C) Stake Holders to Come Forward: Stake holders – students, parents, teachers and owners of colleges of education have to come forward and give information, if any, about institutions which have been granted approval
93 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 by NCTE and where norms and standards as prescribed by the Council have not been followed. Any kind of commercialization being done anywhere in such institutions should be reported in specific terms so that the Council can get the matter enquired and take appropriate action. Conclusion It is very difficult to precisely present such a great issues writhen the stipulated framework. It is no doubt from the primitive society to modern Information Communication Technology (ICT) based society education in general and teacher education is special has significant role for the development of society. Commercialization of education is now a day loosed its own value in particular but in the vision of world globalization it has importance with the pragmatic value. With this importance and possibilities without innervations of teacher education policy makers, government in future it will loose its own identity. It is not only the role of Government but the teachers trainers and management agencies should think above the present requirement and its implementation by which teachers training programme will able to keep its own position and sustain. References Abhishek Gupta, U. M. (2014).Quality Of Life Of Elderly People And Assessment Of Facilities Available In Old Age Homes Of Lucknow, India. National Journal Of CommunityMedicine, Page 24. Raina, V.K. (1998), Teacher-educators. A perspective, Vikas Publishing House Pvt. Ltd. Jangpura, New Delhi Sharma Meenakshi (2001), Commitment among Teachers. University news 2001 January Volume 51 Dave R.H. Towards effective teacher education (monograph) IAST, ShikshanMahavidyalaya Gujarat Vidyaptith, Ahmedabad Shah D.B. (2004), ShaikshanikSnasodhan, University GranthNirman Board, Ahmedabad Rao D.B.(2004), Successful Schooling, Shanty RaoPrakashan New Delhi Rao V.K. Quality Education, Shanty SarvayPrakashan New Delhi. Singh L.C.(2004), Commercialization in teacher education, research presented to university, Maharashtra Kurt M. Landgraf(2002), Testimony on Teacher Preparation and Accountability before the Twenty-first Century Competitiveness Subcommittee, House Education and the Workforce Committee on “Training Tomorrow’s Teachers – Providing a Quality Postsecondary Education” National Research Council, Testing Teacher Candidates: The Role of Licensure Tests in Improving Teacher Quality, (March 2000) Wenglinsky, H.(2002), Teaching the teachers: Different settings, different results, (Princeton, NJ: ETS Policy Information Center).
94 GERONTOLOGY IS MY LIFE AND YOUR LIFE JAPAN HOKKAIDO KITAMI 2020 VISION WITH PHILOSOPHY OF APPLIED GERONTOLOGY Ryo Takahashi* Abstract Gerontology is a study to be humanlike human. The study introduces to find a philosophy of Gerontology based on individual historical back ground which can be applied to all humans in the world. Upon the principal of the above philosophy the following summits and activities are planning in Kitami, Hokkaido, Japan as follows: International Youth Peace Ambassador Summit & Indigenous Leaders Summit: Training Workshop (YPA?in Kitami 2020 are planning with philosophy of Samurai Spirit with no power and no authority but truthfulness and action on Aug 18-23, 2020 before Tokyo Olympics (July24-Aug9) and Paralympic(Aug25-Sep6) in Japan for a creating new world in 2030 in Hokkaido, Japan. This paper introduces principle of Gerontological philosophy how making action will be happened for creating new future and society. Key words: Gerontology, Philosophy, Hokkaido, Kitami city, Shibata Town, Tokyo Paralympics, Olympics, Shichijuro Ito, Kai Harada, Masamuine Date, Sendai University Introduction Sendai University is the first university specialized in physical education and sports & health sciences in northern Japan(Shibata Town, Miyagi Prefecture), and has strived to focus its full attention on the relationship between physical activity and bodily function since 1967. Sendai University will remark for its 50th Anniversary Celebration in 2017. Its motto is "Practical Science & Ingenuity based on Originality." This philosophy was established by Hozawa Gakuen founder, Miyoji Hozawa (1822-1895). Shibata Town is known as the historical location of Date Family Disturbance that took place in the 1660s and 1670s by the a historical novel, which is called The Fir Trees Remain (1954-1958) written by Shugoro Yamamoto (June 22, 1903 - February 14, 1967). This paper explains contents of Philosophy of Gerontology which teaches a way of life human being(Ansello 2009). The philosophy of Gerontology is to know the truth to make action to achieve dream and vision in the future. Momi no ki wa nokotta (The Fir Tree Remained) 2017 is Masamune Date's( September 5, 1567 - June 27, 1636) 450th birth anniversary. Masamune is the founder of the modern-day city of Sendai. Masamune is a character in a number of Japanese period dramas as a legendary warrior and leader.
*1) Professor, Faculty of Sports Science, Department of Health and Welfare Science at Sendai University 2) Director, The Nippon Care-Fit Education Institute: [email protected] 95 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Momi no ki wa nokotta (The Fir Tree Remained) is the most well known an outstanding novel written by Shugoro Yamamoto(Yamamoto 1969). This nobel is based on the Yamamoto portrayed Kai (Munesuke) Harada (1619-May6, 1671) who was born in Funaoka Castle where Sendai University is located at Shibata Town. Kai Harada was grandson of Masamune Date and Kai was a supporter of Tsunamura Date(1659-1719). Sansom (1963) wrote about Date Sodo or Date Disturbance during1615- 1867. It explains the details as follows: 'In 1660, the daimyo (feudal lord) of the Sendai Domain, and clan head, Tsunamune Date was arrested in Edo, for drunkenness and debauchery. The charges are generally believed to have been true, but the arrest was probably encouraged heavily by certain vassals and kinsmen in the north. These vassals and kinsmen appealed to the Council of Elders in Edo that Tsunamune was not fit to rule, and that his son Date Tsunamura, great-grandson of Masamune, should become the daimyo. Thus, Tsunamura became daimyo, under the guardianship of his uncles, Munekatsu and Muneyoshi. Ten years of violence and conflict followed in the domain, reaching a climax in 1671 when Aki Muneshige, a powerful relative of the Date, complained to the shogunate of the mismanagement of the fief under Tsunamura and his uncles. The Metsuke (Inspector) for the region attempted to deal with the situation, and to act as a mediator, but was unsuccessful against Aki's determination. The Metsuke reported back to Edo, and Aki was soon summoned there to argue his case before various councils and officials, including the Tairo Sakai Tadakiyo and members of the Roju council. Following his arrival on the 13th day of the second lunar month, he met with and was interrogated and examined, as were several other retainers of the Date on both sides of the dispute. One retainer in particular, a supporter of Tsunamura and his uncles, by the name of Harada Kai Munesuke made a particularly poor impression in his meetings, and is said to have left the interrogation in a sour mood. Towards the end of the month, all the Date retainers involved were summoned to the Tairo's mansion for a further round of questioning. It is said that over the course of the day, Harada grew increasingly distressed as he realized the extent to which his answers clashed with those of Aki Muneshige (Dobashi 1975). According to one version of events, Harada, following a series of questions, was waiting in another room when Aki came in and began to shout insults at him. Swords were then drawn, and Aki was killed. Fig.1. Kai Harada’s Tomb 96 Takahashi / Gerontology is My Life and Your Life Japan Hokkaido Harada was killed moments after, by the officials or their guards. A trial was soon held, the murder being made a more severe crime for having been committed in the home of a high government official. The official verdict was that Harada drew first, and the punishment was severe. The Harada family was destroyed, Harada’s sons and grandsons executed, and though Tsunamura was affirmed as the proper daimyô, his uncles were punished. Aki was judged to be a paragon of loyalty, and no action was taken against his family.’(Fig.1; Mihara 1975; Date Sodo Wikipedia ). Shugoro Yamamoto’s Belief and Living Philosophy A ten years old boy, Shugoro had chance to read a book titled Harada Kai(Murakami 1928). He took more than 40 years to approve that Harada Kai is truly righteous and noble man by offering his life(Akiyama 1979;Fig.2). Mr. Shugoro Yamamoto said: ‘The issue is not what happened on such and such a day in the year 1600, but the sadness experienced by an apprentice in some merchant household in a neighborhood in Osaka . . . To explore what he tried to do from that sadness: that is the role of literature.’ There is a philosophy behind of all literatures by Shugoro Yamamoto(June22,1903-Feb14, 1967). This year is Shugoro yamamoto’s 50th memorial year, as well. Shugoro was born in impoverished circumstances. Because of a lack of money forced him to drop out of secondary school, but Shugoro continued his education Fig.2. Shugoro Yamamoto’s Tomb part-time, while living as a boarder above a used bookstore. His pen-name came from the name of the store where he lived(His real name is Satomu Shimizu). One of Shugoro’s literature ‘Nihon Fujin Fudoki (Lives of Great Japanese Women)’ was nominated for the 17th Naoki Award, one of Japan’s most prestigious literary prizes, but Shûgorô refused to accept, stating modestly that his “popular writings” should not be considered “literature”. It symbolized the degree or position of the world is not the real power to influence to human nature, but experience will gives truth and real influence. That should be considered the real philosophy of Gerontology who guides how to live. Shichijuro Shigetaka Ito’s Living Philosophy One of the most influenced followers by Kai Harada was Shichijuro Shigetaka Ito(1633- June7,1668). Shichijuro studied Neo-Confucianism called Wang Yangming Studies (Japanese: Yomeigaku by Banzan Kumazawa (1619 – September 9, 1691) and Yamaga Soko ( 21 September 1622 – 23 October 1685) who was a Japanese philosopher and strategist under the Tokugawa shogunate(Goto/Tomoeda 1971). Soko applied the Confucian idea of the “superior man” to the samurai class of Japan. This originally became an important part of the samurai way of life and code of conduct. Shichijuro Shigetaka learned not only theory, but also application with action(Authorless 1982:181-186). Shichijuro Shigetaka was planning to attack Munekatsu Date 97 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 who planed secret political change against the direct Date family with his brother Uneme Shigekado Ito. But, this plan was leaked and arrested. Shichijuro Shgetaro decided to stop eat for 33days and wrote the following message by his mouth due to both hands were bound 4days before his execution. ‘When emergency came to man, the hope became simple. Man chooses the most important in Life. Old words saying never give up ambition when your life is dangerous. And Fig. 3. Shichijuro Ito’s Last Words in Japanese saying unto you even you are killed, do not be ashamed. And saying unto you I have no guilty with clean soul. This is my ambition.’ (Fig.3) Shichijuro Shigetaka Ito was executed on April 28, 1668. All Shichijuro Shigetaka Ito’s family was arrested, executed, punished. Because of Shichijuro’s death the society starts to think the way of using a power and an authority. Shichijuro’s Samurai’s way of life was informed in Capital area Edo. Finally, Munekatsu Date’s power has been weakened and arrested with clarified witnesses. And all people of the society praises Shichijuro Shigetaka Ito’s name and all his related family’s rights were restored. When Shichijuro Shigetaka was executing, he was saying to executor, Manuemon. ‘Oh Manuemon, Listen to me very carefully, I will die with no sins. For this witness usually he failed in front when his neck was cut off, but I will see the heaven that you will know God will be with me. Within the three years I will destroy Munekastu after becoming to be the deity SOUL. Manuemon could not cut full of the neck. Then, Shichijuro Shigetaka fixed his own neck to urged Manuemon saying ‘Do not be hurry up. Be calm and cut off!!!.’ Then, Manuemon tried second time and fully cut off Shichijuro’s neck, but his body looked up the heaven. Later Manuemon testified that Shichijuro Fig.4. Saishoin Temple 98 Takahashi / Gerontology is My Life and Your Life Japan Hokkaido Shigetaka Ito was real righteous Samurai and Manuemon repented and built up the memorial stone of Shichijuro Shigetaka Ito at Amida Buddhist Temple. Shichijuro’s Body was not known due against the Shogunate position. However, Shichijuro’s supporters have been kept holy in secret at Saishoin Temple in Sendai, Miyagi(Fig.4). Saishoin was built for Kubohime(1521-July26,1594) who is grandmother of Masanune Date. Fig.5. Shichijuro Shigetaka Ito’s Tomb Sendai’s original name was came from Saishoin Temple because there are thousand Goddness of Mercy means thousand and Dai means Generations. Sendai means thousand generations that symbolizes Generations will be continued for time and eternity that means. Later, Masamune Date changed the character to Sendai that way original Sendai name came from. There is Shichijuro Shigetaka Ito’s Tomb in Saishoin Temple. But, it was considered as a real but a symbolism without his remained body (Fig.5). However, it was discovered hidden remained Ashes of Fig.6. Shichijiro Ito’s Shichijuro Shigetaka Ito by the mortuary tablet Chief Priest(Saito 1918; Fig. 6). In the cover the name was written as Shichijuro Ito Sensei as respected soul(Fig.7). The next year 2018 will be Shichijuro Shigetaka Ito’s 350th memorial year (Saito1970). Such Bushido spirit has been continued to the next generations to the generations. The author’s mother side ancestors are from Shibata areas. Murata Town is known that the first son, Hidemune Date was born( November 11, 1591 – July 8, 1658). Though he was Fig.7. Shichijuro Ito’s ashes Masamune’s eldest son, Hidemune was born by a concubine, and therefore could not be the successor to the Sendai Domain, which his father ruled after legal Wife, Megohime had a son, Tadamune(Jan. 23, 1600-Aug. 10, 1658), Hidemune’s role has been changed and sent over to Another locations including Kyoto, Edo, and Uwajima as an adapted child(Ugami 2013;Fig.8). Masamune therefore considered the possibility of having Hidemune start a branch family. Fig.8. Hidemune Date’s Tomb 99 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
That shows history is remained within father side roots(Sato 1995:100-111). Therefore, it is important to know of the real roots of mother side, as well. The most of all descendants who immigrated to Hokkaido came from the main island of Japan except AINU people . In 1899, the Japanese government passed an act labelling the Ainu as “former aborigines”, with the idea they would assimilate. As the result, the Japanese government taking the land where the Ainu people lived and placing it from then on under Japanese control. At this same time, the Ainu were granted automatic Japanese citizenship, effectively denying them the status of an indigenous group. All AINU history is still existed within the most of all names of the locations in Hokkaido(Gouda 2013; Gouda 2011). That is why know of true history of yourself and myself are beginning of the creating the new world. Ryoma Sakamoto(Jan 3, 1836 – Dec. 10, 1867) was a Japanese prominent figure in the movement to overthrow the Tokugawa to build the new world in Hokkaido. Ryoma wrote in his last letter a few days before his death, ‘I had dream to immigrate to Ezo to create New Country.’(Miyaji 1995) Ryoma’s associates, Enzo Kishimoto and Masaomi Kitadai wrote their letter that aborigines were forced to be slavery work more than South American, Black people. However, if pioneering Ezo land truly, we must love natives to nature and work together.’(Haraguchi 1996 ). The Hokkaido was explored by Ainu. Then Japanese people came from another islands after 12 century. Ainu people has their own languages and cultures (Lam 2017). Ainu means Man or real man. Samurai’s sward is called Katana. This original meaning came from Settlement, Village, or Clan. However, Japanese government has destroyed Ainu lives to become themselves as Japanese. That is human discrimination (Sarashina 1955). On the other hand, Dubreuil(2007)reported that Samurai's culture and way of life is originally from Ainu. Wilford(1989) introduced as follows " Dr. Brace and his co-authors, M. L. Brace and W. R. Leonard, said that when the emperor in Kyoto wanted to subdue unruly inhabitants on the eastern frontier, the area around present-day Tokyo, generals usually recruited armies from the very residents meant to be controlled, the Ainu. This practice had gone on for nearly two centuries, and these recruited warriors became the revered samurai, sword-wielding knights in armor whose exploits led to six centuries of military rule in Japan". Finally, Ryoma's vison was continued to his relatives and associates as Hokkosha. In 1897, a group of immigrants comprising 112 families, Hokkosha, who migrated from Kochi Prefecture, settled in Kitami, Hokkaido. Hokkosha was established by Naohiro Sakamoto (Nov. 5, 1853-Sep. 6,1911), who was a nephew of Ryoma Sakamoto, a hero of the Meiji Restoration(Hashimoto 2013; Okamura 2000). 5. Conclusion Gerontology is for Improving Quality of Life by know individual's genealogy. This paper begins from Sendai University 50th anniversary where the author was a student at Sendai University in 1980. After graduating from the university it was found that the author's mother- side ancestors lived in Murata town, Shibata Town, and Shiroishi area where the university is located at. That is called Alma Mater which means nourishing mother in Latin. Above all things
100 Takahashi / Gerontology is My Life and Your Life Japan Hokkaido have been related to Family History. Gerontology itself is study of Life span of Human Family Science. Gerontology is known his/her values who we are, where we are from, where we will go the life after death. That is reason why it is important to know of the History of ourselves. Sendai University 's roots goes back to Miyoji Hozawa(May5, 1822-Nov. 5, 1895)(Date 2016). Hozawa family goes back to Hidesato Fujiwara (unknown -991) (Noguchi 2001; Takahashi 2016; Fig.9). Hidesato is known as a Fig.9. Hidesato Fujiwara's Tomb famous for his military exploits and served under Emperor Suzaku, and fought alongside Taira no Sadamori in 940 in suppressing the revolt of Masakado Taira(Ooka 1975, Murakami 2008). On the other hand, Masakado Taira (Unknown-Mar.25, 940;Fig.10) is known as a demigod to the locals who were impressed by his stand against the central government, while at the same time feeling the need to appease his malevolent spirit. This is the first historical fight against the government and local people. The history of wars is recorded as one is right(The Winner) and the other is wrong(The defeated). For example, Ashio Copper Mine Incident is the first man-made disaster in Japan. The Ashio Copper Mine Incident is the name given to the environmental disaster that occurred as a result of the Ashio mining operations since1878. Within a decade, the fish population had been almost completely destroyed and around 3,000 fishermen in the Fig.10. Masakado Taira's Tomb area were put out of work in Yanaka Village (Koike 1972; Yanakamura to Moro Chikasuke Wo Katarukai 2001). Later, 66 families had moved to Saroma near Kitami for creating new lives. That human made disaster has been affected to even after 139years in 2017. Then, Aftermath of the 2011 Tohoku earthquake and tsunami cursed. The tsunami created over 300,000 refugees in the Tohoku region of Japan, and resulted in shortages of food, water, shelter, medicine and fuel for survivors. 15,891 deaths have been confirmed. The Fukushima Daiichi nuclear disaster was an energy accident at the Fukushima Daiichi Nuclear Power Plant in Fukushima, initiated primarily by the tsunami following the Tohoku earthquake on 11 March in 2011. Though there have been no fatalities linked to radiation due to the accident, the eventual number of cancer deaths, according to the linear no-threshold theory of radiation safety, that will be caused by the accident is expected to be around 130-640 people in the years and
101 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 decades ahead. The United Nations Scientific Committee on the Effects of Atomic Radiation and World Health Organization report that there will be no increase in miscarriages, stillbirths or physical and mental disorders in babies born after the accident (Smith 2013). However, an estimated 1,600 deaths are believed to have occurred due to the resultant evacuation conditions. There are no clear plans for decommissioning the plant, but the plant management estimate is about more than 30 to 40 years. Finally, why Budo Enbu keikokai (Martial Art practice Demonstration) for Judo and Kendo is planed is reviewing acting philosophy of Bushido which is required with Meditation, Prayer, or Yoga or Zen practice. This must be the central of Bushido(Benesch, 2014 & Uchida, 2013). With all above histories, teaching principle and philosophy the Gerontology concept has been set up. The following conference has been preparing now. Topics are chosen as follows: Education, Human Rights (Indigenous people), Disasters Management and Environment (Takahashi 2014). All participants are welcomed to gathering to Kitami city, Hokkaido, Japan during the year of Tokyo Paralympics and Olympics in 2020. 2020 Gerontology Conference in Kitami, Hokkaido, Japan International Gerontology Conference Youth is a Gift and Age is an Art International Youth Peace Ambassador Summit & Indigenous Leaders' Summit: Training Workshop (YPA) International Budo Keiko Enbukai for All People including disabilities; in Kitami 2020 Date: Aug 18-23,2020 Location : Kitami city Culture Hall Purpose: Training future leaders from Youth Activities: Youth Summit about Environment, Prevention from Disaster, Education, Human rights for Indigenous people; Budo Keikokai with Hokkaido Sakamoto Ryoma Cup (Judo; Kendo) Aug 18 (Tue) Welcome Budo Keikokai World Indigenous Culture Exchange Festival Pray for World and Peace Aug 19 (Wed) Keynote Lecture & Summit round-table meeting Aug 20 (Thurs) Summit Roundtable Meeting Aug 21(Fri) Field Trip in Abashiri Area Aug 22 (Sat) Field Trip in Aakan Area Aug 23 (Sun) Move to next week for Tokyo Paralympics and other activities Sight Seeing: Hokkaido Museum Northern People http://hoppohm.org/index2.htm Abashiri Prison Musium http://www.kangoku.jp/ Moyoro Shell Mound Musium http://moyoro.jp/ Akanko Ainu Kotan http://www.akanainu.jp/
102 Takahashi / Gerontology is My Life and Your Life Japan Hokkaido
References Akiyama, S.(1979)Akiyama Seiji Taking Photos Notes, Sobunsha, 3. Authorless(1982)Date Soudou(First Vol), Suchi, T.(Trans.), Kyoikusha. Benesch,O.(2014) Inventing the Way of the Samurai, Oxford. Date,M.(2016)Hozawa Miyoji Den, Maruzen Planet. Dobashi, H. (1975) Harada Kai, Seibido. Dubreuil,C.(2007) The Ainu and Their Culture: A Critical Twenty-First Century Assessment, The Asia-Pacific Journal, 5(11)1-70. Goto,Y&Tomoeda, R.(1971)Kumazawa Banzan, Iwanami. Gouda,I.(2013)Hokkaido no Chimei Nazotoki Sanpo, Shinjinbutsu Bunko. Gouda,I (2011)Hokkaido chimei wo Meguru Tabi, Best Shinsho. Haraguchi,I.(1996)Sakamoto Ryoma to Hokkaido, PHP Shinso. Hashimoto,M.(2013) Hokkosha, self published. Koike,Y.(1972)Yanaka kara Kita Hitotachi, Shinjinbutsuouraisha. Lam,M(2017)Land of the Human Beings: The world of the Ainu, little-known indigenous people of Japan, The Washington Post, July27. Mihara,Y. (1975)Miyagino Kyodoshiwa, Hobundo. Miyaji,S.(1995)Ryoma no Tegami, PHP Bunko. Murakami,H.(2008)Masakadoki, Yamakawa Shuppan. Murakami,M.(1928)HaradaKai,Tamaiseibundo. Nogucchi,M.(2001)FujiwaraHidesato, Yoshikawa Kobunkan. Okamura,I.(2000)KitamiBooklet,No.6. Kitami(Kunneppu Genya)wo Hiraita Tosa no Ikotsusoutachi, HokumoukenKitami Culture Center. Ooka,S.(1975)Masakadoki, Chuokoubun. Saito, S(1970) Siberian lupin True Story. Saito Sojiro sensei Kouenkai(1931) Faithfulness of Ito Shichijuro, 8-10. Saito,S.(1918)Ito Shichijuro, 82-88. Sansom, George (1963). A History of Japan: 1615-1867. Stanford, California: Stanford University Press. pp.63-67. Sarashina, G(1955)Kuma Matsuri Iomante, Yu Shobou.
103 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017
Sato,K.(1995)Date Masamune no Tegami, Shinchousha. Smith,A(2013)Fukushima evacuation has killed more than earthquake and tsunami, survey says, Archived from the original on 2013-10-27. Retrieved 11 September2013. Takahashi,R.(2016)Sendai University, Faculty of Sports Science, Department of Health & Welfare Science, 20th Anniversary Foot Step and Future Prospect, Faculty of Sports Science Department of Health and Welfare 20th Anniversary Book, Sendai University, 33-44. Takahashi,R; Anderson, D. R. ; Coover, S., Kikuchi,K.,Scott,R.,&Smith,R.R.(2014)The FEMA and CERT:Training, Guidance, and Managements an Analysis on Cross-Culture Perspectives, Odisha Journal of Social Science,1(2),14-28. Takahashi,R. (2000) The International Studies of the Aging with Intellectual Disability , Japanese Journal on Developmental Disabilities 22(2), 104-112. Uchida,T.(2013)Shugyouron(Vol.651), Kobunshashinsho. Yamamoto,S.(1969)Momino Kiwa Nokotta, Koudansha. Yanakamura to Moro Chikasuke Wo Katarukai(2001)Yanaka mura sonchou Moro Chikasuke, Zuisousha. Ugami,Y.(2013)Uwajimahan, Gendaishokan. Wikipedia (2017) Aftermath of the 2011 Tohoku earthquake and tsunami. Ansello F, E. (2009) Valedictory Comments https://www.carefit.org/india_conference 09/ repo_14.html Care-Fit:http://www.carefit.org/project_3/symposium/ Date Sodo https:// en.wikipedia.org/wiki/Date_S%C5%8Dd%C5%8D Immigrants, be ambitious http:// www.akarenga-h.jp/en/hokkaido/kaitaku/ k-04/ Ito Shichijuro Shigetaka https:// ja.wikipedia.org/ wiki/% E4% BC% 8A% E6 %9D%B1%E9%87%8D%E5%AD%9D Sakamoto Ryoma's Yufutsu secret story http://www.kirari.com/ryoma/yuhutuhiwa.html, Shigetaka Shichijuro Ito https://ja.wikipedia.org/ wiki/% E4% BC% 8A% E6%9D%B1%E9%87%8D%E5%AD%9D Shugoro Yamamoto https://en.wikipedia.org/wiki/Sh%C5%ABgor %C5%8D_Yamamoto http:/ /www.booksfromjapan.jp/authors/cjw/ite m/352-shugoro-yamamoto Sugawara,M: Erekouku no Michiannai. http://www.okhotsk.or.jp/~myoshida/mukashi/e rekouku.htm
104 Takahashi / Gerontology is My Life and Your Life Japan Hokkaido
International Roundtable of Aging with Intellectual Disabilities and Quality of Life https:// www.iassidd.org/uploads/legacy/pdf/ne wsletter-oct-02.pdf http://ci.nii.ac.jp/els/ 110000953503.pdf?id=A RT0001122198&type= pdf & lang =en & host=ci nii & order_no=&ppv_type=0&lang_sw=&no= 1451436569&cp= Takahashi,R.(2009)Gerontology Special Symposium General Review and Future Aims https:// www.carefit.org/img/project_3/symposi um/symposium20091106_sohyo.pdf Takahashi,R.(2009) Message from Director of AU-NCSA Center for Gerontology at the Andhra University http://www.carefit.org/india_conference09/repo _12.html The Voice of Russia (2012) Feb. 7. https://jp.sputniknews.com/japanese.ruvr.ru/2012/02/06/ 65448380.html-slide-1 Wilford,J.N(1989) Exalted Warriors, Humble Roots, The New York Times, June 6. http:// www.nytimes.com/1989/06/06/science/ex alted-warriors-humble-roots.html
105 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 THE BHAGAVAD GITĀ AND HEALTH MANAGEMENT OF PSYCHOTHERAPY
Surya Narayan Panda* Introduction The Bhagavad Gitā is a part of the great epic the Mahābhārata, a widely popular mythological story in Hindu philosophy; part of BhishmaParva, Gitā is almost in its entirety the dialogue between two individuals, Lord Krishna (considered as incarnation of BhagawanVishnu, Nārāyana) and Arjuna (the Pāndava prince, Nara) in the battle field (war between the Pāndavas and the Kauravas, the cousins, for control of the kingdom of Hasthinapura) of Kurukshetra. It has 18 yogas(chapters), with about 701 slokas (short poems),authored by Vyāsa and dates back to 2500 to 5000 years BC. the first one being “ArjunaVishada Yoga” (Sorrow of Arjuna) and the last one “Moksha Sanyāsa Yoga”(Nirvana and Renunciation).the process and content of the dialogue; its usefulness as a model of counseling and possible contemporary application value to current day psychological therapies, specially, but need not be limited to, in the Indian context. The Hindus believe the Gitā to be an essence of the Upanishads (texts that form the core of Hindu philosophy). Arjuna’s dilemma is an allegory of our lives where our internal conflicts related to positive and negative dynamisms are fought on the battlefield of our minds. Teachings of the Gita communicated by Lord Krishna lead us to the right course of action. In many ways, resolution of conflict through the Gita is quite similar to the task of a mental health professional, who while addressing anxiety and conflicts of the patients, also helps them with symptom resolution and paves the path to long-term recovery. Several distinguished Indian psychiatrists have recommended the use of principles of the Bhagavad Gita for psychotherapy and healing. The core theme of the Gita also involves a successful resolution of conflicts faced by Arjuna within the three gunas i.e., tāmsic, Rājas, Sātwic forces, respectively having broader similarities with the id, ego and superego. The Gita & Health Management :- The importance of healthy living in spiritual life is also mentioned by Lord Krishna in the Bhagavad-gitâ as veel³eMvelemleg ³eesieesçefmle ve ®ewkeÀevleceveMvele: ~ ve ®eeeflemJeHveMeeruem³e peeie^lees vewJe ®eepeg&ve: ~~ 6/16 ³egÊeÀenejefJenejm³e ³egÊeÀ®esäm³e keÀce&meg ~ ³egÊeÀmJeHveeJeyeesOem³e ³eesiees YeJeefle og:Kene ~~6/17
*Research scholar, P.G. Dept.of Sanskrit, Utkal University 106 Panda / The Bhagavad Gitā and Health Management of Psychotherapy “There is no possibility of becoming a yogi, O Arjuna, if one eats too much or eats too little; sleeps too much or does not sleep enough; one who is temperate in his habits of eating, sleeping, working, and recreation can mitigate all material pains by practicing the yoga system.” The fact of interest for the student of Psychology lies embedded in the dialogue between these two slokas: keÀeHe&C³eoes Now I am confused about my duty and have lost all composure because of miserly weakness. In this condition I am asking you to tell me for certain what is best for me. Now I am your disciple, and a soul surrendered unto you. Please instruct me. Veäes ceesn: mce=efleue&JOee lJelHee^meeoevce³ee®³egle~ efmLeleesçeqmce ielemevosn: keÀefj<³es Je®eveb leJe ~~18/73 Arjuna said: My dear Krishna, O infallible one, my illusion is now gone. I have regained my memory by your mercy. I am now firm and free from doubt and am prepared to act according to your instructions. The 7th sloka of 2nd chapter is depiction of the helpless state of Arjuna praying Lord Krishna for help. The 73rd Sloka of 18th chapter is reflection of dissolution of anxiety, worry, depression and guilt and preparedness for action with confidence and vigor. Whatever transpired between the 3rd sloka of 2nd chapter and the 73rd sloka of the 18 th chapter is the matter of scientific curiosity for every student of psychology as it resulted in the total relief from the distress. The Therapy :- The therapeutic background: Arjuna is the patient and Lord Krishna the therapist Single session therapy Counselor is a relative of the patient Therapist stays with the patient throughout the crisis Patient has immense belief in the therapist and considers him a friend, philosopher, guide (Guru-Sishya Relationship) Single case report – level 5 evidence in the current day terminology. Blind application of this approach may run the risk of overgeneralization, a commonly found overenthusiastic error in psychology, too obvious in the history of psychoanalysis. 107 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 Therapeutic process:- Cognitive / Rational emotive Approach: Discussion on the natural inevitability of birth and death of life cycle, immortality of soul, performance of your own Dharma (duty) otherwise running the risk of shame and public defame. Goal of therapy is removal of guilt and demotivate for action. DeMees®³eevevJeMees®emlJeb He^%eeJeeoeb½e Yee (You worry about events you are not supposed, and speak like a learned man, Wise people do not worry about things that are perishable, or immortal) Jeemeebefme peerCee&efve ³eLee efJene³e veJeeefve ie=ndCeeefle vejesçHejeefCe ~ leLee MejerjeefCe efJene³e peerCee&v³ev³eeefve meb³eeefle veJeeefve osner ~~2/22 (As you remove torn clothes and wear new ones âtmâ also leaves… and occupies new bodies) vewveb efívoefvle Memle^eefCe vewveb onefle HeeJekeÀ: ~ ve ®esveb keÌueso³evl³eeHees ve Me (âtmâ can never be torn by arrows (bullets), Burnt by fire, Washed away by floods (Tsunami) lifted by winds (Typhoon, Hurricane) peelem³e efn Oe¦Jees ce=l³egOe¦Jeb pevcece=lem³e ®e ~ lemceeoHeefjne³exçLex ve lJeb Meesef®elegcen&efme ~~2/27 (Everything born must die, everything dead must get born again and you should not worry about these events) DeLe ®esÊJeefceceb Oec³e¥ mebiee^ceb ve keÀefj<³eefme ~ lele: mJeOece¥ keÀerefle¥ ®e efnlJee HeeHeceJeeHm³eefme ~~ 2/33 (Your “Dharma” is to participate in war, If not You lose your dharma, fame and commit a sin ) DekeÀerefle¥ ®eeefHe Yetleeefve keÀLeef³e<³eefvle lesçJ³e³eeced ~ mecYeeefJelem³e ®eekeÀerefle&ce&jCeeoefleefj®³eles ~~2/34 (For a noble man disgrace is worse than death) nlees Jee Hee^Hm³eefme mJeie¥ efpelJee Jee Yees#³emes cenerced ~ lemceeogefÊeÿ keÀewvles³e ³eg×e³e ke=Àleefve½e³e: ~~2/37 108 Panda / The Bhagavad Gitā and Health Management of Psychotherapy (If you die you will go to heaven, winning will get you kingdom so get up and decide to fight). Personality of Arjuna: Pandava Prince, no significant neurotic traits, maladjustments or faulty coping pattern; a great warrior and veteran of many battles, in the recent past he fought against the same army and won the battle (UttaraGograhanam). Proactive role in the preparation for the current war and he drove into the battlefield with great enthusiasm to fight and win. Therapist Lord Krishna : A long-time friend, relative, well wisher of the patient, highly respected in the community, supposedly with supernatural powers, legendary mediating skills, mischievous lover boy in his younger days, with tons of common sense and in the contemporary language a kind of Go- Getter. Descriptive psychopathology of Arjuna: Anxiety :- meeroefvle cece ieelee^efCe cegKeb ®e HeefjMeg<³eefle ~ ~ 1/28 (Weakness of limbs, Dryness of mouth, Shivering of the body, Goose skin) ieeefC[Jeb meb^meles nmleeÊJekeÌJewJe Heefjo¿eles ~~1/29 ve ®e MekeÌveesc³eJemLeelegb Ye^celeerJe ®e cesceve : ~ 1/30 (Gandivam slips from the hand, “Burning” of skin, Unable to stand, “Dizziness”/Confusion of Mind) Depression :- 1. Negative thoughts: ve keÀe*d#es efJepe³eb ke=À (Do not desire victory, neither kingdom nor pleasures why kingdom, why luxuries, why this war, wh…..) 2. Guilt: Denes yelecenlHeeHebkeÀleg¥ J³eJeefmeleeJe³eced ~ ³eêep³e megKeueesYesve nvlegb mJepeveceÐeglee: ~~1/44 (Preparing for the sinful act of killing our own kin…) 3. Death wish:- ³eefo ceeceHe^leerkeÀejceMemle^b Memle^HeeCe³e: ~ Oeele&jeäe^ jCes nv³egmlevces #escelejb YeJesled ~~ 1/45 (Even if I get killed in the war by my enemy it will be good) 109 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 Mindfulness :- “Mindfulness” means “awareness” or “bare attention” and refers to a way of paying attention to that is sensitive, acceptable and independent of thoughts. It is a way of being observant without being attached or affected. Though this is widely quoted as a Zen principle, the Gita has several references to this practice. The Gita prescribes mindfulness as a way of being detached from the onslaught of the senses, in order to attain the state of Sthithapragna (a state of unperturbedness). Some of the metaphors in the Gita describing this state are: “One should be tranquil like the ocean which is unaffected by rivers flowing into it,” “one should draw self away from the senses as a tortoise withdraws its limbs” and “being similar to water drop on a lotus leaf which does not have an attachment to the leaf.” Such metaphors from the Gita can be useful in guiding patients towards mindfulness. Lord Krishna suggests reaching the “mindful state” via meditation and maintaining self in calm and un-agitated state. Notions on mindfulness : - Mindfulness is perhaps the most widely accepted eastern concept in psychotherapy. It is used in conjunction with CBT,(cognitive behavioral therapy) DBT( in the form of dialectical behavioral therapy)and Acceptance and Commitment therapy. With the proliferation of eclectic therapies, we can foresee more models using these techniques. Action and renunciation :- The one concept in the Bhagavad Gita that received exceptional respect and applause from several great scholars is the emphasis on Karma (Action). Intelligent action (Gnana Karma) without performance anxiety and without the greed for the fruits of the work (Nishkama Karma) and never to have the choice of nonperformance of duty (Akarma) emerges as a key point in the teaching of the Bhagavad Gita. keÀce&C³esJeeefOekeÀejmles cee HeÀues (You have the right only on Action, not on the fruits of your work. Never do own responsibility to the result, Must never lose interest in work) Humanistic school: Emphasis on the power and capabilities of individual self, and how the person alone will be responsible for his actions, growth or otherwise. “You are your choices”. “You are your destiny” G×jsoelceveelceeveb veelceeveceJemeeo³esled ~ DeelcewJe ¿eelcevees yevOgejelcewJe efjHegjelceve: ~~ 6/5 (Self-Empowerment, No inferiority, Your “Self” can be your friend or your own enemy) Viswarupa-Darsanam - ? Hypnosis: Is the therapist inducing a state of hypnotic trance at this point! 110 Panda / The Bhagavad Gitā and Health Management of Psychotherapy Jesoeveeb meeceJesoesçeqmce osJeeveeceeqmce JeemeJe: ~ Fefvê³eeCeeb ceve½eeeqmce Yetleeveeceeqmce ®eslevee ~~ 10/22 I am the best of everything - Omnipotent, Omnipresent…. HeM³e ces HeeLe& ªHeeefCe MeleMeesçLe menme^Me: ~ veveeefJeOeeefve efoJ³eeefve veeveeJeCee&ke=Àleerefve ®e ~~ 11/5 (Arjuna, Look at my Hundreds and Thousands of forms…) Trust (Bhakthi): Trust (Faith) remains a single most important element in the therapeutic relationship; not just in psychology but the medical practice in general. meJe&Oecee&vHeefjl³ep³e ceeceskebÀ MejCeb Je^pe ~ Denb lJeeb meJe&HeeHesY³ees cees#eef³e<³eeefce cee meg®e: ~~ 18/66 (Leave everything and Trust me, I will rescue you from all the problems, Do not Worry) Guru – Sishya Relationship: Gurukul Tradition :- Imparting wisdom with devotion to learn and teach, dialogue and discussion being the process, bound by relationship of trust is the ancient tradition of Gurukul. Therapeutic components:- Satisfactory premorbid personality of the patient with adequate coping skills Therapist is a trusted Friend, Philosopher, Guide Catharsis, Ventilation! Cognitive and Rational emotive approach! Cognitive Distortions, Misinterpretations (meebK³e ³eesie ) Emphasis on work with renunciation (keÀce& ³eesie), Smart action without performance anxiety (%eevekeÀce& mebv³eeme ³eesie) Behavior Therapy - Flooding!– Prolonged, continuous exposure to the anxiety provoking situation as the therapy was in the battle field itself Insight Oriented ! ( %eveefJe%eeve ³eesie) ViswaRupam – Hypnosis ! (efJeéeªHeoMe&ve³eesie) Trust (YeefÊeÀ³eesie) 111 Odisha Journal of Social Science, Vol. 4, Issue-2 July 2017 (William James) “What mattered is not so much the content of a person’s beliefs / religions but whether or not they led to personal transformation of a positive kind” The Bhagavad Gita has immense value with enormous intellectual depth that analyses and explains a variety of life’s experiences, and attempts to reach out to everyone with any kind of intellectual and philosophical background.The therapeutic model sounds eclectic, as the therapist does not seem to be bound or restricted by any particular theoretical approach. The determined focus on the end result – removing the guilt and re- motivating to fight the battle – and the practical and common sense approach in clearing the blocks is palpable throughout the dialogue. Emphasis was equal on all – Logic, Action, Renunciation, Power of Self, Knowledge, Wisdom, Trust, Universality and immortality of human spirit. This appears to me a “Person-Centered Therapy” (not in the strict sense of Carl Rogers’). Lord Krishna seem to have succeeded in making Arjuna rediscover his emotional balance and power as described in the last sloka of the Bhagavad Gitā. ³ele^ ³eesieéej: ke=À (……Where Arjuna stands with his Gandiva [Bow] there certainly will be wealth, victory and justice – so I believe) “It is not this approach gives power to the person; it never takes it away” Conclusion:- As is the case with any successful model of therapeutic intervention, which needs to be individualized for maximum benefit, the psychotherapeutic approach practiced in Bhagavad Gita also will have its place in the repertoire of psychotherapeutic models and remains a useful tool in the hands of an experienced therapist when applied judiciously for some patients with specific problems of distress. The success of the spirituality based therapies in AA and mindfulness has not resulted in spirituality being embedded in part of routine psychiatric practice. One of the barriers to the application of spirituality in improving the health of patients and promoting healing has been the belief system of psychiatrists themselves. Compared to the general population, there is a high prevalence of atheism and agnostics among this population. There is some line of thought among psychiatrists that sharing religious beliefs amount to boundary violation. However, the dictum of medical ethics is not impinging on patient’s own religious-spiritual beliefs but at the same time religious-spiritual views of a physician should not preclude the prescription of a useful spiritual intervention, which are consistent with the patient’s belief. With a rise in the number of psychotherapies in the recent years, majority being eclectic, we hope for therapy models embedded in the wisdom of the Gita may add additional content to western psychotherapies. 112 Panda / The Bhagavad Gitā and Health Management of Psychotherapy References Bhagavad Geeta, Gorakhpur press. Varma, V.K. & Ghosh, A.(1976) Psychotherpay as practiced by Indian Psychiatrists. Indian J Psychiatry. Surya, N.C. & Jayaram, S.S. (1964) Some basic considerations in the practice of psychotherapy in the Indian setting. Indian J Psychiatry. ;6:153–6. Balodhi, J.P. (1984) Relationship of Itihas and puranas to Vedas: Our vedic Heritage. Bangalore: Chinmayananda Mission; pp. 64–8. Rao, A.V. & Parvathidevi, S. The Bhagavad-Gita treats body and mind. Indian J Hist Satyananda, D. (1972) Psychology of the Gita of Hinduism. London: Oxford and I.B.H. Jeste, D.V. & Vahia, I.V. (2008) Comparison of the conceptualization of wisdom in ancient Indian literature with modern views: Focus on Bhagavad Gita. Psychiatry. 113 GENERAL INFORMATION AND INSTRUCTION TO AUTHORS Odisha Journal of Social Science is a self-financing, blind referred and peer-reviewed bi- annual (preferably, in January and July of every year) journal with inter disciplinary approach. 1. The articles are invited for the Journal with soft copy/print or hardcopy (type material) 2. The font style should be TIMES NEW ROMAN with size 12 and Auto spacing. 3. All articles must be accompanied by an abstract. Begin the abstract on a separate page. Type the abstract as a single paragraph without paragraph identification. An abstract for an empirical paper should be 200-250 words. 4. All articles must follow the style and format as suggested by the publication mannual of the American Psychological Association. 5. The title should be in 15 words or less in length. The running head (within 60 letters) must appear on the title page. The running head is a shortened title to be used for the printed article. 6. Figures and tables must appear on separate sheets of papers. These should be of professional quality and must not exceed 22-28cm. Figures must be drawn on tracing Pagers. 7. The length of the manuscript must be within 20 typed pages including tables, figures and references. 8. Must include all references except personal communications in the reference list. Mention personal communications only in the text. In reference list, place the year of publication in parentheses immediately after the author’s name. Reprints Authors of papers published in the journal will receive free of charge 10 off prints of their paper. Subscription Rates One Issue : $25.00 (foreign); Rs.250.00 (Inland) Subscription are to be sent by Bank Draft of Money Order only to Bhubaneswar Mohapatra, 2624/3484, Baragada Canal Colony, At/Po. BJB Nagar, Bhubaneswar -751014, ODISHA (INDIA) Correspondence All correspondence should be made to : Dr. Santa Misra Chief Editor : Odisha Journal of Social Science 2624/3484, Baragada Canal Colony, At/Po. BJB Nagar, Bhubaneswar - 751014, ODISHA (INDIA), e-mail : santaamisraaftediffmail.com, Mob. : 9457211371 OJSS Membership form 2014 Surname: ………....……...... …….First Name: ...... Mailing Address: ……………………………...... City:……………………………. State- …………………… Postal Code:…………………….. Country:…………………. E-mail…………………………………………………Date Submitted: ………....…….. Would you like to receive the publications [ ] electronically or [ ] paper Person you are sponsoring (if applicable): Surname: ………....……...... …….First Name: ...... Mailing Address: ……………………………...... City:……………………………. State- …………………… Postal Code:…………………….. Country:…………………. E-mail…………………………………………………Date Submitted: ………....…….. Would she/he like to receive the publications [ ] electronically or [ ] paper. Payment Summary …………...... …………………………………………… Category of Membership: PATRON Rs. 10,000 (ONE TIME) CORPORATE MEMBER Rs. 9000 (IOYEARS VALIDITY) FELLOW Rs. 8,000 (ONE TIME) LIFE MEMBER Rs. 10,000(10 YEARS VALIDITY) ASSOOCIATE Rs. 5,000 MEMBER Rs. 3,000 (PER ANNUM) STUDENT MEMBER Rs. 1,000 (PER ANUM) Membership Fee for______Category .TOTAL PAYMENT:______ The amount may be deposited in the account number - 30753198829 , IFSC NO. SBIN 0003341, OUAT, Bhubaneswar, Odisha., to the treasurer, B mohapatra, against OJSS. NATIONAL INSTITUTE OF SCIENCE COMMUNICATION AND INFORMATION RESOURCES (Council of Scientific and Industrial Research) 14, Satsang Vihar Marg, New Delhi 110 067 & Dr. K. S. Krishnan Marg (Near Pusa Gate) -110 012 Ms. V. V. Lakshmi, Head, National Science Library Phone: 91-11-2686 3759 E-mail: [email protected] website:nisrair.res.in NSL/ISSN/INF/2013/1158 Dated: May 22, 2013 Head, Dept. of Psychology, Sri Satya Sai College for Women, Bhubaneswar— 751030 Odisha Dear Sir/ Madam. We are happy to Inform you that the following serial(s) published by you has been registered and assigned ISSN (Print) ISSN 2321 - 3493 Odisha Journal of Social Science It is important that the ISSN should be printed on every issue preferably at the right hand top corner of the cover page. The Indian National Centre will be responsible for monitoring the use of ISSN assigned to Indian Serials and for supplying up to-date data of the same to the International Centre for ISSN, Paris. For this purpose we request you to send us the forth coming issue of your serial on complimentary basis. We solicit your co-operation in this regard. Yours sincerely (V.V. Lakshmi) Head National Science Library Please don’t forget to send a sample Issue of the journal /URL with ISSN printed on it Contact : Ms. Shobhna Vij e-mail : [email protected] phone : 011.26516672