A CASE STUDY ON KARUNALAYAM, GERIATRIC CARE CENTER AT POTHENCODE
A Dissertation Submitted to the University of Kerala in Partial Fulfilment of Degree of Master of Social Work (MSW)
Submitted By Sr.Jazy Joseph Exam Code: 915 06403 Candidate Code: 08 115 018 Subject Code: 2.4.4
DEPARTMENT OF SOCIAL WORK LOYOLA COLLEGE OF SOCIAL SCIENCES THIRUVANANTHAPURAM 2008 – 2010
A CASE STUDY ON KARUNALAYAM, GERIATRIC CARE CENTER AT POTHENCODE
A Dissertation Submitted to the University of Kerala in Partial Fulfilment of Degree of Master of Social Work (MSW)
DEPARTMENT OF SOCIAL WORK LOYOLA COLLEGE OF SOCIAL SCIENCES THIRUVANANTHAPURAM 2008 – 2010
DECLARATION I, Jazy Joseph, do hereby declare that this dissertation titled “A Case Study on Karunalayam,Geriatric Care Center at Pothencode”, has not been submitted for the award of any Degree, Diploma, and Associateship, Fellowship or other similar title of recognition before.
PLACE: POTHENCODE JAZY JOSEPH
CERTIFICATE OF APPROVAL This is to certify that this dissertation on “A Case Study on Karunalayam, Geriatric Care Center at Pothencode ” is a record of genuine work done by Sr.Jazy Joseph, fourth Semester Master of Social Work student of this College under my supervision and guidance and that it is hereby approved for submission.
Dr.Usha John Faculty Guide / Supervisor Loyola College of Social Sciences, Thiruvananthapuram – 695 017 Recommended for forwarding to the University of Kerala
Dr. K. A. Joseph Head, Department of Personnel Management Loyola College of Social Sciences, Thiruvananthapuram – 695 017 Forwarded to the University of Kerala
Dr. Usha John Principal Loyola College of Social Sciences Thiruvananthapuram- 695 017
Acknowledgement
I take this opportunity to heartily express my sincere gratitude to all those who extended their contribution towards this project in various ways. First of all I thank the God Almighty who in the “Source of knowledge” and who guided me in all respect to bring out this work a successful one.
I am very grateful to Dr.Usha John, Principal of Loyola College of Social Science, Thiruvananthapuram, under whose helpful guidance this study was conducted. Her exhaustive knowledge both theoretical and practical helped to avoid many pitfalls during the course of the study. Without her constant interest, encouragement and help, the study could not have been completed.
I am thankful to my Congregation and my sisters who gave me all support and encouragement in carrying this project work. I am also thanks to the Director and all members of Karunalayam for their cooperation in my endeavor. I also thanks to Ms.Maya and Sr.Lissy Chackola for their advice and suggestions to carry out this study.
Jazy Joseph Loyola College of Social Science Thiruvananthapuram
CONTENTS
List of Tables
Chapter Title Page Number
I INTRODUCTION 1-4
II LITERATURE REVIEW
III METHODOLOGY
IV ANALYSIS & INTERPRETATION
FINDINGS, SUGGESTIONS & V CONCLUSION
Bibliography
Appendix
LIST OF TABLES
Table No. Description Page No.
1 Age wise distribution of the Respondents
2 Religion wise distribution of the Respondents
3 Education Qualifications of the respondents
4 Nature of Employment
Marital Status of the Respondents 5
Visits of children and grand children 6
Visits of friends and Relatives 7
Reason for care Center 8
Reason for Compulsion 9
Suffer from illness 10
11 Entertainment/Recreation
Chapter -1
Introduction: -
A Man’s life is normally divided into five main stages viz. infancy, childhood, adolescence, adulthood and old age. Old age is regarded as the final phase in our life span that begins at approximately sixty years. Aging is generally associated with fatigue and decline in functional capacity of the organs of the body due to physiological transformation. The status of aged varies in different societies and cultures.
Old age is subject to stresses and strains. Old age is usually regarded as synonymous with pensionable age or age of retirement. This stage is characterized by certain physical and psychological changes that are far more likely to lead to poor adjustments and unhappiness than to good adjustments. The elderly persons are generally considered a spent force that has out lived their utility for the growth of the society. Old people, whether wealthy or poor are considered and treated as excess members of the family and the society.
Old age is a significant phase in a person’s life. Ageing is a normal, inevitable and a universal phenomenon. (Guruswamy, 2001)
Robert. C. Atchiey in his book “The Social forces in later life: An introduction to social Gerontology (1972), mentions the four main aspects of ageing namely biological, psychological, be hand and sociological, all of which are inter connected in the lives of the older people.
India has a rapidly, growing population of the aged. It houses over 73 million elderly people; of this 34 million are women and more than half of them are widows. Among the Indian states, Kerala has the highest population of elderly. The population percentage of aged over 60 was 8.28 in 1991 and 10.73 percent in the year 2001.
In many families it is no longer possible to provide care for an aged loved one at home, particularly when that person is in the morbid state. With advancement in medical technologies, it is now possible to extend the life of a person with the help of life saving
1 mechanisms available but at the same time, the person would not be in a healthy condition also. To look after a bedridden person is very difficult considering the busy lifestyle of a typical nuclear family of today. Socio – cultural development such as the higher revalue of single part in the family and families in which both parents work outside the home have contributed to a situation in which it is now frequently unrealistic for a younger family member to provide assistance of the quantity and duration needed by many frail elderly people. (HOPP – 1999)
Elderly people are those who have completed their normal span of economic activities. Lower age limit is 65 years in developed countries but it may be taken, as 60 years for countries like India where persons are expected to retire from services on reaching 58 or 60 years of age or those outside service sector are unable to work participation by 60 years due to health problems. A review of studies of fertility decline in developed countries leads to the conclusion that it results in a wide range of demographic and social changes which have set up a new life style and social trend in which have set up a new life style and social trend. The average age of the population has increased and increasing number of young females are not only refraining from child bearing but also from mortgaging their future life to marital life.
An inevitable consequence of continuing low fertility is the ageing process which is very slow initially but accelerates later. When fertility decline to a very low level and is kept for some decades, the population growth rate will be reduced and the age composition will become, at least for some considerable years, favourable for economic development because of the large size of the working age population and a low dependency ratio such as in Japan in the Sixties and the Seventies. Passing through that stage which may last for a few decades, a country with low fertility rate would start facing problems of ageing, first slow but rapid afterwards. Changes of age structures due to ageing have profound social, economic and political consequences, many of which are not understood at the beginning. Elderly persons make considerable demand on health and social services because of illness and disabilities that accompany ageing.
2 It is also true that many older people do not have living members with whom they could reside, whereas many others would prefer not to do so instead wish to remain in an autonomous living situation if at all possible.
In this context, we should find out the relevance of the old age homes. A home should not remain an isolated unit any more. The aim should be to create a home away from house with fair amount of flexibility and opportunities for community elders to interest with the residents in more than one way. But the leading factors of the old ages are different. Kerala is a rich state in this regard when compared to other states. There are various types of old homes in India. Government and Private Institution are common.
Statement of the Problem
Geriatric care has been an important area of concern in the social work domain. The changes that had occurred over the years in the family structure and in the economic life of the people resulted in the need to evolve institutional care for the aged. Geriatric or the process of being aged is seen as a social concern mainly because of the loss of status one achieves after a certain age due to decrease in income on one side and health issues on the other side. The dependency on other family members is influenced by the sources of income, the type of occupation as well as the availability and attitude of the family. Things get worse after the death of either spouse or in the case of serious health problems.
Geriatric Care Center has emerged to meet this need. Retirement homes and day care centers offer services. The affluent class can afford the services of such institutions. But the case of poor people is different, especially for the poor aged women. They may be in a miserable condition owing to lack of nutritious food and proper health care. The psychological stress of being felt useless worsens their situation. The relevance of an institutional framework for the aged poor is thus manifest.
Karunalyam at Pothencode in Thiruvananthapuram district provide geriatric care for the aged destitute women from 1991 onwards. This study looks into the functioning of
3 Karunalayam by focusing on the services they provide, their mode of resource mobilization and the life of inmates. Such a study could provide insights into the possible social work interventions in the field of geriatric care.
Relevance and Scope of the Study
The Sociological aspect of ageing is concerned with the changes in the circumstances of the individual as a member of the family, community and society. The results of the present study would contribute to the discipline of social gerontology as it is concerned with the changes in social characteristes, status and roles of the aged. The findings of the study will provide a vulnerable framework to assess the problems and the preference of the elderly in the cultural perspective. The findings will make a worthy source material not only for Sociologists, Psychologists, Gerontologists and Social workers, but also for the government and non- government organizations working in the field, to formulate plans and policies taking into consideration the preferences and opinions of the elderly. Lastly the study will also give an insight to the aged themselves of their socio cultural milieu and provide them necessary strategies to adjust themselves to the changing social environment. The present study encompasses the several factors that the elderly of today face. The scope of the study is to analyze the living preferences of the elderly and the impact on it by the changing values changing family structure, changing status and roles in the family.
General objective
To Study the functioning of the Karunalayam Geriatric Care Center in a detailed manner.
Specific Objectives
To study the history, objectives and programmes of Karunalayam
To study the staff, supportive service and administration of Karunalayam
4 To understand the methods adopted for resource mobilization
To identify the problems faced by Inmates
Definition of Concept
Geriatric Care
Geriatric Care is the especially that concern itself with the provision of nursing service to Geriatric or Aged Individuals. Geriatric care focus on improving the physical and mental health of older people.
Operational definition
In this study geriatric Care is to promote health and prevent and treat disease and disabilities in older persons. Providing geriatric care to older persons is important because it grants them access to health care, medical resources and services that they would otherwise have trouble reaching if they live alone or family with limited financial resources. It also aims at helping the poor, disabled and needy ones.
5 Chapter – 2
Literature Review
Introduction
The scientific study of all aspects of ageing –health, economic, psychological and environmental has been termed ‘gerontology’ which is a multidisciplinary field.
“Grow old along with me!
The best is yet to be, the last of life, for which the first was made.
Our times are in his hand, who saith: “A whole I planned, youth shows
but half: trust God; see all, nor be afraid.”
Robert Browning
Old age is man’s most paradoxical and contradictory stage of life. It is the time when life’s last question arises with full intensity, allowing no illusions and demanding solutions to what is unresolveable. Old age is an integral process that extends to the entire organism.
“Last scene of all
That ends this strange eventful history
Is second childhood and mere oblivion
6 Sans teeth, sans eyes, sans everything”
William Shakespeare
In our highly and competitive and progress oriented society often the aged members are neglected. Becoming old is now treated as a problem; segregation and isolation of the age from the mainstream life, causes them to confront with many psychological problems. (Ward, 1979)
Generation gap in human adjustment has invited worldwide – attention of social scientists. Findings have shown as to how in every society the old generation differs from the younger generation in cognition, attitude, values, personality and total mental makeup. A comprehensive work on inter generational gap in Indian society in respect of Psychological manifestations was done by Sinha (1989) Teachers on dimensions like perception of people and events, motivation, concept of happy life, values, attitude and reaction to frustrations. The results indicated international gap in good many dimension but it was not as wide and functional as generally expected. The fewer psychologists have provided enough data on impairment and decline of mental abilities during old age.
Ageing today has become a subject of specialized scientific enquiry of interdisciplinary nature in which the social scientists, particularly the psychologists have started taking keen interest. Psychologist, sociologists and anthropologist are trying to solve the problem of ageing from their own angles. From Psychological view point, ageing express itself in typical perception and awareness as of limitations, handicaps and problems, overall dissatisfaction and difficulties of adjustment on account of advance age and typical strategies adopted by the aged to copy with them. So, precisely speaking a review of pertinent studies will be presented on the following aspects. Sinha (1989) Problems, life satisfaction and strategy of adjustment of the aged people as well as the effects of advancing age.
CONCEPT OF AGEING
7 Ageing is a normal inevitable and Universal phenomenon. Literally it refers to the effects of age. Commonly speaking, it means the various effects or manifestation of old age. In this sense it refers to various deteriorations in the organism. Ageing has three aspects biological, psychological and social. Beckar (1989) defines ageing in the broader sense as “changes occurring in an individual as the result of the passage of time”. Tuckman and Lorgal mention that both young and old people look upon old age as a stage characterized by economic insecurity, poor health, loneliness, resistance to change and failing physical and mental powers. Bengtson, Kasschan and Regan – According them “ageing represent one of many aspects of reality which properties and problems are constructed within the context of shared expectations particular to specific groups”.
Barren and Renner: Characteristics of Aging: -
1. Ageing is a process of regular changes
2. It occurs in mature genetically representative organism
3. It is a result of advancement in chronological age.
Ageing in socio – cultural perspective
Impact of a Socio – Cultural factors on ageing has assumed remarkable significance in recent years. Mooney found that at present of the Psychological problems of old age seem to be a consequence of the democratizing the effect of personal poverty, social alienation and cultural deprivation. Traditionally the aged are given respect in Indian society. But the various facts of advancement have been weakening the Psychological bands between the young and the old. In the changing circumstances life style of individuals has changed everywhere and so in India. A part from socio – economic changes like modernization, industrialization, price rise and cost of living, increasing employment of women in offices and factories implies that they can spend less time in taking care of the older members, especially those who require constant care.
8 In Indian society children have usually been considered as a source of security and economic support to their parents, particularly in times of distress, sickness and in old age. The problem of the aged arises only when the needs of the aged cannot be met by the social groups to which they belong particularly their families. (J.N.P. Sinha. - 1989) Leonard has reported that marital status, occupational prestige, years of formal education, race, annual income and specific life satisfaction measures are significantly related to successful ageing.
In short, ageing is substantially influenced by socio cultural variations and the research findings on ageing cannot be interpreted properly without understanding the socio – cultural perspective of the sample studied.
Demographic details of elderly in India
In India, 9.7% of the total population is elderly. In 1981, the number of persons over age 60 was 42.5 million; this number is expected to increase to 75.9 million in 2001. The average proportion of elderly in India as a whole was 6.8% in 1981 until 1971 when annual growth rate declined. The population of 60 + years shows a definite increasing trend from 0.5% projected to 5.97%. in 1971 and 6.91% projected for 1996. (Iruduya Rajan 2000)
Demographic details of elderly in Kerala
According to the census of 2001 Kerala had a population of 31, 838, 69 of whom 15,468,664 were male and 16,369,955 were female. The decadal population growth rate has gone down from 14.32 in 1981-1991 to 9.2 in 1991-2001. The major fall in the birth and death rates which started since 1961 has resulted in Kerala experiencing the demographic transition much earlier than others India states. This has also accelerated the ageing process to the state as already mentioned. The population of the 60 + in the population of Kerala rose steadily in the second half of the last century from 5.83% in
9 1981 it moved up to 8.8% in 1991. It was projected to be 9.79% in 2001, 11.74% in 2.11 and 15.63% in 2021 (Irudya Rajan, 2001)
Demography of aged people
Elderly person are those who have completed their normal span of economic activities. Lower age limit is 65 years in developed countries but it maybe taken as 60 years for countries like India where persons are expected to retire from services on reaching 58 or 60 years of age or those outside service sector are unable to work participation by 60 years due to health problems. A review of studies of fertility decline in developed countries leads to the conclusion that it results in a wide range of demographic and social changes which have set up a new life style and social trend in which average age of the population has increased. The increasing number of young females are not only refraining from child bearing but also from mortgaging their future life to marital life.
Inevitable consequences of continuing low fertility is the ageing process which is very slow initially but accelerates later. When fertility decline to a very low level and is kept these for some decades, the population growth rate will be reduced and the age composition will become, at least for some considerable years, favorable for economic development because of the large size of the working age population and a low dependency ratio such as Japan in the Sixties and the Seventies. Passing through that stage which may last for a few decades, a low fertility country start facing problems of ageing, first glacially slow but rapid afterwards. Changes of age structures due to ageing have profound social, economic and political consequences, many of which are not understood at the beginning. Elderly persons make considerable demand on health and social services because of illness and disabilities that accompany ageing.
Inter – Social Group Variation of Percentages of Aged Persons
Selection of the method for organizing welfare services to aged persons will largely depend upon the attitude of the people who. will use them. Rural people living with grand sons and daughters would not normally like to move away from joint families or ancestral homes and live in isolated places. On the other hand, if homes are built by
10 the Government in a planned manner for aged person they may be forced by the family to seek shelter in these houses rather than keeping them in the family. They may have to face more health hazards because of senility development earlier. As mean ages of different sections of rural population are very much different from each other, it would be interesting to study the old age percentages of males and females of different social group in terms of caste/ religion. In the absence of age data communities form Indian censuses, household survey data relating to Calcutta and rural areas of Bihar and West Bengal are being used in this Chapter. Social groups- high caste Hindus and other in Table 8.2 cover persons in Calcutta speaking mostly Bengali, Hindi and small percentages of persons of other languages. 60+ had remained practically unchanged till 1951. There has been substantial increase in the number of person in the age group 0-14 years and slight increase in the age group 60 years and above during the subsequent decades. Overall dependency ratio increased to the high figure of 92.25 per cent in 1971 in the ratio 80.8: 11.5 between children and aged. The percentage from the 1981 census was 85.52 per cent in the ratio 73.5: 12.1 between the young and the aged. It indicated highest dependency burden in the Indian population in 1971 compared to the previous decade. Lower children percentage but higher aged percentage was observed in 1981. Indian population as a whole has entered the kingdom of ageing and will experience economic prosperity in coming decades. Old age dependency ratio will be more by the end of the twenty first Century.
Inter- State Variations of Percentage of Aged Persons
Inter- State Variations of distributions of children belonging to age groups 0-4 and 5- 9 yeas and aged persons by State and sex of 1971 and 1981 censuses have been examined in 1981 census publications. Figures, as published, are appended in a Table for ready references. The analysis is restricted to 16 major States of India excluding Assam. States have been arranged in the Table by female education level above primary based on 1971 census.
More than 2 per cent reduction of children percentages in age group 0-4 years were found in 7 States namely West Bengal, Kerala, Haryana, Utkal, (Orissa), Madhya Pradesh,
11 Maharashtra and Gujarat whereas it was slightly less than 2 per cent in the Southern States of Tamil Nadu and Karnataka. Low order reduction for Northern States of Uttar Pradesh and Punjab was observed.
All the States exhibited lower percentages of children but percentages of aged persons were higher except for Haryana in 1981 compared to corresponding 1971 figures. Percentages of aged persons of both sexes of Haryana were lower in 1981 perhaps due to female education backwardness and lower utilization of health services. Low level(less than 0.21) increase of percentages of aged person in 1981were observed for West Bengal, Jammu & Kashmir and Uttar Pradesh States. Lowest improvement rates of aged males in West Bengal may be on account of appreciably of migrant males in ages 15-59 years in Calcutta and other industrial towns. Other two States are backward in female education.
Less than 3 per cent aged males were found in Gujarat, Madhya Pradesh and Rajasthan in 1971 and it has become more than 3 per cent in 1981. Less than 3 per cent aged females were found in Jammu& Kashmir and Rajasthan in 1971 and the increase of percentages have been 0.12 and 0.82 respectively by 1981 but aged female percentage of Jammu& Kashmir remained below 3 per cent.
2.5 Variabilities of percentages of aged persons were statistically examined and found that variation due to State was highly significant and due to State was highly significant and due to sex was insignificant. Error estimate based on 64 figures was 0.35 and difference more than 0.68 would be significant at 5 per cent level. Differences less than 0.35 may be ignored.
It was found that male percentages were higher than those of females in Himachal Pradesh and Jammu Kashmir for both the census years 1971 and 1981. Male percentage of Punjab of 1971 only was higher than females significantly but the difference narrowed down in 1981 whereas male percentage of Haryana decreased by lower amount in 1981 increasing the male-female difference.
12 Kerala only exhibited significantly higher percentage of aged persons of both sexes in 1981compared to those of 1971. Ageing process of Kerala females followed by males was faster than other States in India. Improvement of percentages of aged males and females have been 0.75 and 1.00 respectively during the 1971-81 decade.
Percentages of aged persons in 1981 in respect of Himachal Pradesh, Punjab and Kerala of both sexes were significantly higher than those of 7 Status namely Tamil Nadu, West Bengal, Gujarat, Andra Pradesh, Jammu & Kashmir.
Calcutta, 1970
Although social group combined lines of Table 8.2 show higher percentages of aged females than males, the pattern does not apply to other Hindus and Muslims living in Calcutta slums perhaps due to poor health and lower longevity of females. Highest percentages of aged persons are found among high caste Hindu females followed by males in non-slum areas whereas the percentage is lowest among other Hindu females followed by males in slum. Difference of percentages of aged males and females is insignificant. Except for Hindi speaking and Urdu speaking populations in Table 8.3, sample size is so large that observed percentages in Table 8.2 may be taken as having small error of estimates.
Considering ages 65 and over, about 5.0 per cent per-sons among high caste Hindus in non-slum in Table 8.2 compares with about 2.0 per cent aged persons among other Hindus in slum. These figures change to 8.9 per cent and 3.4 per cent respectively for females considering ages 60 years and over whereas corresponding male percentages are 7.3 per cent and 4.2 per cent. It shows that hygienic condition have more adverse effect on the longevity of women in ages over 64 years in respect of educationally backward population.
Rural Areas of Bihar and West Bengal
Percentages of aged Scheduled Tribes are not shown in Table 8.4. Only 0.63 per cent and 0.16 per cent aged males and females, respectively, were found in region 3 compared to
13 4.52 per cent and 1.94 per cent respectively, considering ages above 59 years. Data for Scheduled Tribe households were not available for region 2.
Factors Determining the Age Structure of the Population
Role of Fertility:
Whether a population of any country is “young” or “old” is determined mainly by the fertility of the women in that country. When fertility is high, birth rates are also high and the number of children born by these women is large and the population is “young”. One the other hand, when fertility is low, birth rates are low, the number of children born is low and the population is “old”. When birth rates are high, the population has a larger proportion of children relative to the adults of parental age. The sustained high levels of birth rates result in a large proportion of children and a small proportion of “old” people.
It may, therefore, be concluded that the economically developed countries have experienced an aging of the population because of their declining birth rates, while the age structure of the developing countries has remained virtually unchanged because their birth rates have remained more or less at high levels, though their death rates have been declining since the 1950s.
Role of Mortality: What is the role of mortality in determining the age structure of a population? It has been observed that mortality affects the age distribution to a much lesser extent than fertility. The effect of a reduction in mortality on the age structure is just the opposite of what one would imagine. Empirically it has been demonstrated that the high and rapid reduction in mortality and the prolongation of the life span have resulted in a “younger” age distribution. An explanation of this phenomenon is to be sought in an understanding of the process of the decline in mortality rates.
Role of Migration: Migration, the third component of population change, can also affect the age structure of a population. Two important factors have to be taken into consideration for determining this effect: the age distribution of the net migrants and the volume of net migration. If the proportion and the number of young adults among the net
14 migrants are large, the effects of the aging of the population tend to get retarded. Since these young adults can participate in reproduction, they also add proportionately to the flow of births. If, on the other hand, net migrants contribute mainly to the increase of those who are above the age of 30, the aging process tends to get accelerated. Thus, whether the age distribution of a population would be affected, and if so, in what direction, would depend on the volume and the age distribution of the net migrants.
The Effect of Wars and Natural Disasters: The age-sex structure of a population is also directly affected by wars, as war causalities usually occur mainly among men in the younger age groups. Wars also affect the age structure because of the indirect effect they have on fertility. During a war, men in the armed forces are separated from their wives for long periods; this inhibits fertility. In the immediate post-war period, however, there is often a “baby boom’, because couples unite once again, and marriages, which were postponed because of the war, are solemnized.
Nature disasters like floods, earthquakes etc. may also affect the age-sex structure of a population as such disasters may affect children, women and older persons to a greater extent than young men.
Determinants of Ageing Effects
While many old people experience variety of problems, maladjustment and reduced life satisfaction, these are many others who do not carry pathological symptoms and feel as much satisfied with their life as they ever had been.
Age
Age is one of the significant variables influencing ageing have reported the impact of chronological age on self resting classification as ‘young’, ‘middle aged’ or old. There are several other studies which have shown the influence of age on the attitude towards ageing. The effect of age on the attitude towards ageing has been found as significant in different cultures and societies.
15 Bake (1980) have reported that age has a pronounced effect on most of the measures. Wass et. al. (1978-79) have reported that certain life parameters out weight the commonality of advanced age in influencing the attitude of elderly persons towards certain aspects of death and dying. Busse et. al. (1957) has reported that age is markedly linked with the feeling of old age group. Sinnott (1978) has stated that age does not appear to strongly relate to task performance when other variables are controlled. Cameron (1969) is of the opinion that perceived age stages has significant association with the age of the subjects. Kayak (1982) has reported that age and environmental perceptions on most dimensions.
Age is a condition that is not measurable by years but by attributes. The decisive factor should be individual work capacity or age functional rather than chronological age. Higher age causes certain physiological and biological weaknesses and deficiencies which lower down individual’s activities. Wesl (1975) states that sexual activity diminishes after the age of 50 and ceases after 60. Remamurti and Parameswaran (1963) reported that the younger groups were quicker on mirror tracing and also committed lesser number of errors. The older group had taken longer time and committed larger number of errors. In an early study Ruch (1934) found that learning was slower in the older years and habit changing was more difficult. These hints at the underlying- physiological mechanism. Papalia (1974) compared subjects of varying age on certain cognitive tasks and noted that generally lower levels of cognitive functioning were found in elderly subjects as compared to adult group. Several possible interpretations of these differences are offered. Neural degeneration, isolation, terminal drop and methodological insufficiencies are found as the factors influencing cognitive performance in adulthood. Barren (1960) has reported that age-differences in psychemeter skills may be due to a deficit in information transduced from environmental stimuli. In a similar study Riege et. al. (1981) have found that older subjects in 60+ make more omission and distortion errors than younger subjects in the age group of less than 40 years. Dye (1982) has reported that the manner of function in later life becomes deficient in quality rather verbal in quantitative performance. Gaylord (1975) by using verbal stimuli found age dependent difference in time required for memory scanning processes. Ramamurti (1971) has shown
16 a decrease in positive and favourable attitudes in the higher age groups which seem to accelerate after the age of 40. His trend of data suggests than even in age group of 50+, the advancement in age determines ageing effects in significant manner. From studies cited earlier it is evident that advanced age makes persons emotionally weak and causes certain pathological symptoms like greater apprehension of death and adjustment problems.
Retirement
Retirement is an important turning point in the life of activity of every individual. In business and profession one lives an active life till his health permits. But for the service class people there is a fix age of retirement which of course varies from society to society. In India it varies generally between 55 and 62, whereas in the U.S.A. the usual superannuation is sixty-five. Whatever be the retirement age, this bring a new phase in individual’s life and ageing has much to do with. Generally retirement age is accepted as the cutting point for the aged and most of the studies concerning ageing effects have been done on retired persons. The effects to retirement have been so often referred to in the literature on old-age that psychological consequences of retirement have become over- emphasized (Birren, 1960)
According to Mani (1980) retirement makes man dependent, dull and lonely despite comparative good health. But Rao (1975) has correctly conclused that the retirement benefits are seldom adequate to meet such financial burdens as building of a house, wedding of daughters, etc. which are common at about this time in the life of every person. Retirement deprives an individual of a major part of his income and reduces his status, authority, power and importance. As a consequences of all this, retirement appears to have a negative effect on personal adjustment in so far as there is economic deprivation and attendant feelings of difficulty in keeping oneself occupied (Thomson et. al. 1960). Kaplan (1952) has found that the retired persons report a severe decrease in interest especially in family and social leisure activities, and an even greater decrease. Bell (1975) finds a significant decline in life satisfaction of retired aged but no significant changes in role behavior in three related areas of family, voluntary associations and
17 community. So many retired people seek reappointment or engage themselves in some activity. It has been observed that retired men who do not find a fresh job die sooner than they could otherwise. So, Maddox (1974) has rightly said that work after retirement is related to a personal dislike of retirement, intension to work after retirement, pre- retirement involvement in work and presence of younger friends working, superannuation. Similarly after retirement about half the persons do not seek any paid employment. Not only this, Reichard et. al. (1962) popular study of 87 old-men between the ages of 55 and 84, indicated that the retired men were more active in domestic job, house-hold maintenance, social visiting and pursuit of productive hobbies. They showed as much, if not more, political interest as the in service people. They were, on the whole, less anxious than the younger men and saw their advanced age as an achievement in its own rights and something to be proud of. They were also less defensive, less suspicion, and less erratic in their social relationships.
Contradictory ageing effects in post-retirement period may be accounted for two important reasons. Firstly the retirement carries a number of other aspects and factors which interact to produce the ageing effect in positive and negative form. Health, creativity, economic-status and socio-economic class are some of the important factors which interact with retirement to determine ageing effect. So far (1970) and Levy (1978) have shown how retirement is perceived differently by low paid working class men and men of high socio-economic class. The second reason of varying post-retirement ageing effect is preparation of retirement. One who develops appropriate attitude and makes mental preparation for retirement, he is neither shocked nor unhappy with his superannuation. Douse (1974) has stressed the need for the pre-retirement education which teaches people to deal effectively with their leisure time. Fengler (1976) has shown that an understanding of the wife’s reaction to her husband’s retirement can be useful in understanding the adjustments that both husband and wife may have to make in their relationship to each other. Preparation of retirement is helpful in finding adjustment to their changed condition. But Jacobson (1974) has said, pre-retirement counseling schemes may not be able to compensate for failure to develop lifelong habits of using free time constructively as for inadequate financial provision for retirement.
18 It is evident from the above discussion that in a society where people have to struggle to find means of livelihood and financial strain is an important source of frustration, retirement is generally viewed with apprehension and received as shock.
Socio –Economic Status (SES)
Studies have shown that socio-economic status accounts for considerable variations in ageing effect of individuals. In the poor working class, individual’s work engagement starts at early age. Child labour is common for low SES group. Ageing effects in terms of deterioration in physical and mental health also set in at an early age in them, as compared to middle and high SES groups. Retirement has also a different meaning for the rich and the poor. It aggregates the damaged economy of the poor wage earner. The reduces income and economic depression affect more severely the power rather than the higher socio-economic group (Dublin and Lotke, 1946). Taietz and Larsen (1956) have pointed out that economic factor act as important determinant of social participation in old age.
Palmore and Stone (1973) have reported that the three variable of socio-economic status, viz., education, occupation and continued employment, account for more than two third of the variance in the longevity of older persons. Mortality rates for males generally show an inverse relationship with income although the evidence is not conclusive (Riley et, al., 1968). Health, status and socio-economic status have been found inversely related specially in the old age. Epstein and Murry (1967) have reported that the number of days in which more than half of the day light hours are spent in bed or in the hospital, is inversely related to income. McTavish (1971) reviewed studies related to socio-economic status and ageing and concluded that there tended to be a negative relationship between SES and stereotyping old people. Persons of higher economic status help less negative attitudes towards ageing than did persons having lower status. McPherson (1978) found that socio-economic status, perceived health expressive, job satisfaction and degree of leisure orientation were positively associated with each other. Mooney (1978) has shown that at present many of the psychological problems of old age seem to be the
19 consequence of demoralizing effects of personnel poverty, social alienation and cultural deprivation.
Analyzing the relationship of living arrangement with sex, Epstein and Murray (1967) have shown that low income group people in the old age normally take decision to share house-hold. On the other, the elderly people in the SES generally prefer to own houses rather than to share the house-hold with so many persons. They further noted that people with their greater financial resources do have superior health, independent living arrangements and better social contacts as compared to lower income status. Making studies in Indian set-up Sinha (1972) and Kakar (1979) has reported physical proximity and informal relationship in the living of poor class families. This is similar to the findings obtained from the Western society in which it has been demonstrated that actual Kin contact is more frequent among blue collar people than among the white collar people having higher status (Aldous and Hill 1965; Kerckhoff, 1965; and Rosenberg, 1970). Beyer and Woods (1963) have reported that higher income elderly are less likely than lower class elderly to live with their children. Adams (1970) has observed that much of the visiting in middle and low income groups occurs with siblings rather than with parents and thus the elderly in blue collar families may, in fact, receive less direct attention that do elderly in high SES families. However, this might have might have much to do with the cultural impact and how much this is practiced in rural and urban parts in India may be a matter of investigation and discussion.
Attitude towards the aged also varies with SES groups. In a study by Rowow (1967), when people were asked who should help and take care of older people having difficulty or problems, middle class respondents consistently answered the family, while the working class people answered other organization, viz. government agencies churches, unions, etc. He further found that one sixth of the older working class persons reported that they had no good friend where as 25% of the lower class and 44% of the middle class older people reported having more than ten good friends. Participation of elderly in community activities political programmes is closely related to socio-economic status at all stages of life cycle. Biley et. al. (1968) have stated after examining the census data that among the elderly the best educated persons are likely to continue voting whereas
20 among the lessor educated people voting drops off with age. They further found that membership of voluntary organization is also positively related with the SES and the decline in such membership with advancing old age is less obvious in high SES group than low SES group. Videbeck and Knox (1965) however, found that church activity showed no significant difference among persons of the three SES group.
Some other studies have also pointed out that life satisfaction and social adjustment in the aged are related to socio-economic factors. Studies have shown that in lower SES groups elderly people tend to exhibit less satisfaction and poor social adjustment even when health and other relevant factors are controlled (Alston and Dudley, 1973; Gurin, Veroff and Feld, 1980; Kutner et. al., 1956; Streih, 1956).
Personality Factors
It has been stated earlier that individuals differ in respect of ageing effects. Even within the same social group individual differences are noticed which indicate the significance of individual’s psychological makeup and personality in determining his/her adjustment and other ageing effects. In fact personality and adjustment are closely interlinked. As mentioned earlier good adjustment express itself in confidence, contentment, self-esteem, and freedom from morbid emotions which are all personality dimensions.
Personality characteristics have been found meaningfully related to ageing effects in a number of studies (Edwards, 1961; Havighurst, 1953). Bromley (1974) has mentioned that personality factors like anxiety, rigidity, depression and dependence, are related to poor adjustment of the aged. Certain other studies have indicated significant relationship between self-esteem and social ageing (Cain, 1964). Hunter et. al. (1981-82) have found that low self-esteem aged subjects had poor self-reported health, more pain and higher incapability. Sinha (1971) has shown that creative and intellectual workers show relatively little deterioration in old age. Oden (1968) has reported from his studies that healthier and brighter older people have a number of characteristics indicative of better personal adjustment. Ramamurti (1978) has indicated a substantial negative relationship between rigidity and adjustment of old people. Certain other studies have shown as to
21 how anxiety and apprehension of death increases result in the poor adjustment among the aged people.
Importance of Elderly
Ageing is a natural and irreversible life process. Like every other personal in the life span, old age is characterized by certain physical and psychological changes and the effect (Hurlock – 1977)
In a pamphlet published by Help Age India, we can read as follows “Our country has nearly 60 million elderly people today and demographic projections forecast arise up to 75 million by the year 2000. A very large percentage of the aged constitutes the poor and the destitute who are denied of even basic necessities of life, namely food, shelter and clothing. With the decreasing death rate and increasing longevities, this segment of our society is growing at a rapid pace. Their problems and miseries are further compounding with urbanization and break in joint family system which has been their traditional support.”
According to 1994 census, 8 percent of India’s population was aged 60 and over which is a relatively large elderly population for a developing country. Statistics say that by 2021 the elderly will make up 20 percent of the states population.
Problems of the aged
The word ‘Ageing’ has been defined variedly by researchers in different contexts. Becker defines ageing in the broadest sense, “as those changes occurring in an individual, as a result of the passage of time”. According to Stieglitz ‘ageing is a part of living. It begins with conception and terminates with death. Tibbttis says “ageing may best be defined as the survival of a growing number of people who have completed the traditional adult roles of making a living and childbearing”. Old age is also called “later adulthood” and according to some psychologists begins at the age of fifty one.
22 The optimum minimum age fixed for treating a person as ‘aged’ varies from country to country. In India, the attainment of the age 55 has been mostly accepted for the purpose of classifying aged persons. The Census of India have accepted 55 years as the age for treating a person as ‘aged’.
In a cross – cultural perspective problems of the aged has not received sufficient notice. Generally speaking, when a situation or issue is not solved by one’s available knowledge and skill, it is called a problem. Problem in always relative.
Seal has highlighted various problems of the aged and their genesis. He has divided their problems in to national, special (community and family) and personal (physical, psychological and socio – economic).
Backman has reported that older man and women suffer from rolelessness, powerlessness and depression. With ageing there is decline in many fuctions which lead to feelings of inadequacy and insecurity.
Elderly people are becoming one of the most significant groups in the society. The sacred scripture teaches, man was created in the image of God. He is capable of knowledge and loving his creator.
Old age is frequently discussed not a stage of life but as a problem of residential accommodation, social amenities and medical attention. For a large number of people it is a period of disappointment, dejection, disease, repentance and loneliness. In order to find some so lace for their distressed mind good number of people turn forwards religion, Old age, thus has its physical and psychological problems. K.G.Desai (1982)
Physical problems:-
As the people grow older, the bones become more brittle and joints become less elastic. Elderly people are most commonly affected by circulatory disturbances, metabolic disorders, involutional mental disorders, disorders of the joints tumors, heart disease rheumatism, arthritis, visual and hearing impairments, hypertension and gait disorders.
23 Apart from these problems, the aged faces the physical incapacities like decrease in the efficiency of kidney up to 50% the lungs may lose an average of 30 to 50% of their maximum breathing capacity. The brain may lose 20% of its weight. Literally thousands of brain cells or neurons are irreplaceably lost day after day. Muscle mass begins to decline as well. At 60, a man has half the muscle strength in his biceps as he had when he was 25. Between the ages 30 and 70 the average person loses 30 to 40 percent of the body’s muscle mass. The main diseases suffered by the aged are diabetis, artherosclerosis, cere brovascular accidents, cance, turberculosis, asthma etc.
Malnutrition in old age is due more to psychological than to economic causes. The most common psychological causes are lack of appetite resulting from anxiety and depression not wanting to eat alone, and food aversions stemming from earlier prejudices. The most elderly people lose some or all of their teeth. Those who must wear dentures often have difficult on those high in carbohydrates chewing difficulties also encourage the swallowing of larger and coarser food masses, which may lead to digestive disorders. Sexual deprivation or unfavorable attitude towards sex in old age affected the old person in much the same way that emotional deprivation affects the young child. Happily married elderly people are health a live longer than those who never married, who have lost a spouse, or who become sexually inactive. J.N.P.Sinha (1989)
Psychological Problem
It is possible to say that the overwhelming proportion of the elderly are mentally ill although no period of life is free from the specter of emotional distress, Older people encounter a high risk than any other age group. The increasing proportion of older people in modern civilized societies has given rise to many psychological, social and medical problems. The growing incidence of mental disorder is very much associated with old age. Both men and women are influenced by cultural beliefs and stereo types of aging. This is hazardous because it encourages the elderly to feel inadequate and inferior. Women tend to be more affected than men. Another psychological problem of old age is feeling of inferiority and inadequacy that come with physical changes. Many elderly
24 people suspect or realize that they are becoming somewhat forgetful, that they have difficulty in learning new names or facts.
Senile Dementia: - Older people who suffer from senile dementia develop some symptoms like poor memory, into lerate of change, disorients restlessness, a gradual formation of delusions and hallucinations, extreme mental depression and agitatedness etc. psychosis with cerebral Arterio selerosis; this is accompanied by symptoms such as weakness, fatigue dizziness, headache, depression, memory defect, periods of confusion, lowered efficiency in work, heightened irritability accompanied by suspiciousness. J.N.P.Sinha (1989)
One of the major responsibilities of civilized societies is to take care of their vulnerable groups. The aged are one such group. As the individual grows older (specially beyond 65 years) his health begins to decline. At an advanced age, an individual may not be able to take care of himself in day-to-day life. He may also become financially dependent because he may not be able to earn his livelihood; and large numbers from the disadvantaged sections of society do not have savings to fall back upon. An old person may become socially vulnerable because he may find that his status in society has declined, and in his own family he may not receive the same importance. He may become psychologically vulnerable and experience loneliness, and may even become senile at a later age. He may be subject to the stress of anxiety over his future-failing health, declining mental abilities, depleted financial resources and the care and attention he will have at the time of his death.
The elderly in developing countries are proportionally less in number, and are not organized and therefore, politically ineffective as a pressure group. Their problems are likely to be accorded a low priority by the government. Therefore, an important role will have to be played by voluntary organizations to fill the big gap in services.
Financial problems
In the country like India, where two-fifths of the population is below the poverty line, a large number of persons in old age are left with very inadequate incomes. There are a
25 number of women, who have only been housewives and have never been workers, whether in wage employment or in self-employment. There are men, who have been agricultural workers or employed in lowly paid jobs, or been self-employed, all providing meager earnings. And there may be persons who have been working in the organized sector but are now retired and have to live on reduced incomes. Some studies have indicated that within about five years after retirement, a large number among them exhaust their savings and become dependent on their children or relatives. Pensioners are another vulnerable group whose earnings are affected by inflation. An organized group of pensioners can bring pressure on the government for fully neutralizing the increase in the cost of living. Another problem group is that of the destitute elderly. Although State Governments have evolved schemes for the destitute elderly, their implementation is far from satisfactory. The bureaucratic hurdles are enormous and many eligible persons are not registered under the scheme. There is need to carry out surveys and gather factual information about the magnitude of the problem. J.N.P.Sinha (1989)
As one grows old, their control over the finance of the family slips from them. Individuals who are required to retire and deprived of their main source of living may have to face these problems. Individuals who are dependent on these may face these problems if these persons die or become infirm, or the individuals may face these problems because of their increased need for medical assistance in old age.
If a person has a problem of failing health, he may have to face increasing medical bills and so add to his financial worries. So, the health problem contributes to the financial problem. The failing health of an individual may make him more irritable and thus make his family members more annoyed and so our old man has a problem of adjustment in his family setting. If he keeps on brooding about his failing health he may have a problem of mental “illness”. K.G.Desai (1982)
Probably the mental difficulties are more than the physical. As physical health goes down, the mental urge for recreation, sympathy and acceptance grows higher. Mental retirement is worse than physical. The psychological impression of retirement makes the man dependent, dull and lonely in spite of what health he possesses.
26 Nature of problems that the old people are required to face may differ from individual to individual. The age of an individual may make a lot of differences in the nature of problems. The problem of old people in their sixties are quite different from those in their eighties. The problems of old men would be different from those of women. The problems of persons who are required to retire from their service are different from those who are, say, self-employed and are not required to retire from their services. For persons who are required to retire from their services, the problems may be more severe. An individual in active service gets a certain income, is kept busy for the major part of the day time, has a standing in his society, and family because of his status as a working man. But after retirement, he has to face loss in regular income. He may not get same respect either from his family members or from the society. To add his burden, he will also have to cope up with his increasingly failing health. Prior to retirement, the individual is considered a useful members of the society, taking care of the family. But after retirement, the same individual is regarded as a useless old man and quite a nuisance. K.G.Desai (1982)
At present, retirement and advancing age, seem to bring meaningless misery mainly because the elderly have been neglected and by-passed by modern society. Neglect of the aged by the family leads to the social problems of beggary. The aged living in enforced retirement, not only suffer from chronic diseases and frailties of their age but also from the unhappiness caused by their feeling of uselessness, loneliness and despair. The principal enemies are loneliness, lack of socially useful occupation and physical inactivity resulting in a harmful change in the person’s rhythm of life.
The traditional joint family system provided a place of honor and security to the aged. There is a gradual shift from joint family norms to nuclear families. The aged ones feel neglected and lost in their own homes where they once wielded and authority in the distant past.
The problems of the old are steadily increasing in their magnitude. Though the financial problems seem to be urgent, psycho-social adjustment also needs to be looked into. The changing values and the expectations of the society, in recent times of self dependence,
27 self-reliance in old age, too, make it imperative for every ageing person to prepare well for old age.
Health problems:
It is a biological fact that when one becomes old, health and vigour decline. There are, however, individual differences also. Some individuals continue to enjoy good health even in old age whereas others have poor health even in their forties and fifties. Studies have shown that there are some ailments which are more common among elderly people (asthma, rheumatism, etc.). In very old age, difficulties are experienced in carrying out day-to-day activities. Therefore, the very old have to lead restricted lives. Some suggestions are made here to minimize the sufferings of the elderly in availing medical facilities. Hospitals and public dispensaries are usually over-crowed and persons have to wait in queue for a long time. Separate queues for the elderly will be of great help. The elderly patient is most likely to experience transportation difficulties in going from his residence to hospitals and back. One can think of organizing such a facility. The elderly may require some aids to lead a normal life such as spectacles, hearing aids and crutches. One can even think in terms of a health visitor or a nurse who can make home visits and help the elderly in coping with health problems. Old persons also require medicines, vitamins and tonics at subsidized cost to maintain their health. Many elderly persons need advice on how to maintain their health. J.N.P.Sinha (1989)
Socio-Psychological Problems:
In the past the elderly were respected for their sagacity and wisdom. Now the situation has changed in many ways, and the elderly do not get the respect they deserve. In a large number of cases their presence is tolerated; they are often not treated well. Those, who can afford, do not, therefore, want to stay with their children or relatives. This is also reciprocated by the young who want to establish their own house bolds and leave the old people to fend for themselves. This unfortunate situation can be mitigated by the elderly themselves to some extent. As a group they can think of some socially useful activities and implement them. Individually, they can be useful to their family members. With more women seeking and securing employment, the help of the elderly is needed in a
28 home where both husband and wife are working. Grandparents can look after the children, help them with their school lessons and assist in shopping and in light domestic work. Retired people can also take up some problems faced by the community which need to be sorted out at the level of the government or the local authorities.
The psychological problems faced by the elderly can be a matter of great concern. Failing health, continuing ailments, poor financial situation and humiliation in the family can all add up to feelings of helplessness, hopelessness, depression and anxiety. Such persons need assistance. It is here that groups of the elderly can provide company, solace and help. In every community the elderly should be encouraged to form associations which can plan activities which are useful to the community and demonstrate to others that they are still useful citizens. A day for the elderly can be observed in the same manner as children’s day or teacher’s day to focus the attention of society on the needs of the elderly. K.G.Desai (1982)
Before we attempt to analyse the problems of the aged, we need to look into the proportion of the aged population to the population, to understand the dimensions of the problem.
Our ancient culture demands that the aged should be respected. In fact, the order of prevalence in India has been mother, father, teacher and God in that order. Since times immemorial most of the traditional families in India cling fast to the belief that since it is the duty of the parents to look after their children, it is equally incumbent upon children to look after their dependant parents.
But, industrialization, urbanization complexity of life and growing individualism have changed all that. The problems of the aged in India are gradually taking the same shape as those in the western countries where family ties and sentimental attachment have been given a decent burial. A wide gap separates the growing generation from the decaying generation. While in Europe and in America, there is at least an awareness of the problems in India matters have been allowed to drift.
29 Due to improved health facilities, there is an increase in the longerity of people, from 30- 40 years some decades ago the 50s and 60s. It is worthwhile here to note the opinion of the World Assembly on the Ageing held at Vienna in July 1982.
Life expectancy at birth of an average Indian increased from 26 years and 11 months between 1921-30 to 32 years and 5 months between 1941-50 and to 44.96 years during 1951-60. By the end of the decade 1961-70, the life expectancy at birth of an average India has risen to 52.6 years, and in 1981, it is 54.4 this is likely to rise still further during the coming years with rapid expansion of medical facilities.
The increasing number of the aged in the society is likely to be accompanied by various problems connected with the welfare of the dependent group of population.
Ageing is a phenomenon which has to be accepted. In every stage of life we have problems. Life without problems may not be worth living. So we cannot say that only old age is problematic.
Social Problems
Old people may have to adjust to a life devoid of much activity. The problem is more crucial for persons who are required to retire from their active life. Old people may be required to face the problems of adjustment to the loss of spouse or loss of friends. They have a lot of free time and do not know what to do with it and hence utilization of leisure time may be a problem. J.N.P. Sinha (1989)
Theories of Ageing
Theories of normal aging address why people age; how they feel and experience aging; how roles, social relationships, and community affiliations vary over time; and in what ways social structural factors and institutions affect aging. This chapter examines four aspects of aging; biological aging, which is concerned with the physical aspects of aging which focuses on the individual and the intrinsic processes that may change with age (including sensory capacities, perception and cognitive abilities, and coping skills);
30 social-psychological aging, which examines the intersection of the individual with his environment and historically emphasizes social roles, family and social relationships, and adjustment to aging; and the sociology of aging, which considers social constructions of aging and economic and systemic influences that affect the organization of an aging society.
Biological theories of aging
Biological aging refers to the physical changes that occur in vital organs, tissues, and appearance over time. According to Cristofalo (1996), aging is not an event or one thing that happens; rather it is “a period of the life history of organisms that begins at maturity and lasts for the rest of the life span”. Biological aging is also characterized by an increasing vulnerability to environmental change, which many refer to as senescence. Biological aging results from intrinsic and environmental sources and a combination of these (H. T. Blumenthal, 2003). Although genetic factors may be especially influential during the prereproductive stages, the accumulation of insults during the post maturation years eventually takes its toll.
Most experts differentiate biological aging from age-related diseases (see, for example, Olshansky, Hayflick, and Carnes, 2002). According to H.T. Blumenthal, “Aging and disease are not synonymous. There are processes of aging and etiologies of disease. The relationship between the two is important, but not inevitable.” Although manifested differently among people, biological aging is universal and results in death, whereas age- related diseases affect only certain people. Many changes evolve with age, such as the graying of hair, menopause, presbyopia, and other age decrements, but these age changes are not diseases; they are normal losses of function. These changes do not necessarily increase people’s vulnerability to death, although decreased immune system functioning does increase susceptibility to disease that can lead to death.
Most contemporary theorists concur that biological aging and senescence occur as a result of the attenuation of natural selection forces, but they disagree about the nature and extent of these forces (Masoro, 2002; G. Martin, 2003). The theorists also distinguish
31 biological changes caused by alterations in genetic structures from those caused by extrinsic sources, such as disease, accidents, and toxins. Although genetic processes may determine longevity indirectly, biological changes with age-the losses of physiological capacities that occur after the reproductive stage-are more often the result of random events that are not genetically determined (Hayflick, 1995; Olshansky et al., 2002). Thus most biological theories of aging are concerned with longevity determination, not age changes in biological functioning. This is an important distinction because it implies that losses in vision, hearing, and stamina do not necessarily affect longevity rates and that people can still live for many years despite the deterioration of these processes.
Personality changes
Carl Jung was one of the first psychologists to consider the psychological changes that occur in the latter part of the life cycle. Earlier theorists of psychological aging assumed that most of a person’s personality, values, and beliefs were formed during childhood and that adulthood was primarily an experience of juggling various roles, such as marriage, work, and parenting. Psychoanalytic theories, such as those of Freud (1949), reinforced these ideas by emphasizing stages of development in children. These theorists assumed that the basic personality forms during the first five years of life and then serves as the underlying foundation from which later needs and desires in adulthood are expressed.
Carl Jung (1933, 1960) organized psychological development two stages: the preforty stage and the postforty stage. In the first stage, according to Jung (1933), people are confronted with demands from the outer world, specifically, family and career responsibilities. Jung believed that people expand their social networks and turn outward as they struggle to find their niche in the occupational world and in their families.
The second stage, according to Jung, involves a reassessment of the first. This is an introspective stage, precipitated primarily by biological changes that occur with age. These biological changes confront people with their mortality and lead adults older than forty to become more reflective about meaning and purpose in their lives. Jung viewed this stage as a time of turning inward, or a period of contraction, when people reflect upon who they are and who they are and who they want to be often this leads individuals
32 to recognize other aspects of themselves that they previously have not expressed. Jung believed that most people suppress these other aspects of their personality during the preforty stages, when they must conform to society’s expectations for them as spouses, parents, and workers. The recognition of the finiteness of life, precipitated by many biological changes (in taste and smell, eyesight, hearing, tough, sexuality, and physiological capacity), causes people to redefine their priorities and their commitments. Neugarten (1973) called this period the “return of the repressed”, when whatever a person suppressed during the first stage of life bursts forth. By recognizing previously concealed aspects of themselves, people become more accepting of themselves, that is (in Jungian terms), more “individuated”, more aware, and more accepting of their idiosyncrasies. In this respect people become more integrated and more androgynous. Men who previously silenced the more feminine aspects of their personality become more nurturing and affiliative; women become more autonomous and assertive. David Gutmann (1964) and others, including Sheehy (1976) (who refers to this as the stage of sex role reversal), believe that these changes are inevitable and are linked to reproductive capacities. Others view the “return of the repressed” more broadly, in that whatever a person suppressed emerges later, although individual variations in the process prevail. Whatever the reason for this period of reassessment, most people confront their mortality at some point during their adult year. This often leads not only to a greater acceptance of themselves but also to an increased tolerance of others. In the lexicon of Carl Jung (1969) people become “more individuated” with age. The numerous studies that document extended heterogeneity with age corroborate these ideas.
SOCIAL - PSYCHOLOGICAL THEORIES OF AGING
Role Theory
Role theory was commonly used in the late 1960s and early 1970s to explain adjustment to late life. It was often applied to widowhood and retirement to explain the behavioral changes that occur after these life events. According to role theorists, society is structured around various roles that prescribe norms and expectations regarding behavior and attitudes. Some argue that personality is comprised of the different roles that people
33 occupy in their lives or that a specific set of roles is the culmination of an individual’s existence (Blau, 1973; Cottrell, 1933). Although theorists have presented various definitions of role, Thomas and Biddle (1966) conclude that it commonly refers to a set of prescriptions defining the proper behavior for a position. A position is a collectively recognized category of people differentiated on the basis of a common attribute, common behavior, or the common reaction of others towards them. The category must be distinct in the minds of most people (Thomas and Biddle, 1966). Presumably, roles are socially defined, that is, role behaviors are learned (Strean, 1979). Examples of roles include worker, student, spouse, parent, and caregiver (Thomas and Biddly, 1966).
Streib and Schneider (1971) and Blau (1973) were among the first to apply concepts from role theory to late life, specifically, to retirement and widowhood, respectively. Streib and Schneider as well as Blau hypothesized that the work role is not of the most important that individuals (especially men) assume and is a strong source of a person’s identity.
Disengagement Theory
In their outline of disengagement theory Cumming and Henry (1961) postulate that order people gradually and inevitably withdraw from the various roles that they occupied in middle age and reduce their level of activity or sense of involvement in life. Cumming and Henry theorize that elders turn inward and become increasingly preoccupied with themselves. Cumming and Henry also argue that this disengagement is demonstrated by a shift in preference from the more engaging, affective, obligatory, vertical ties of work and family to less demanding, less affective, voluntary, horizontal peer relations. Although Cumming and Henry believe that this shift is inevitable and intrinsic, they acknowledge that the smoothness of the transition depends upon other social events. According to Cumming and Henry, an older person’s withdrawal benefits society. They used a systems framework to explain the relationship of the individual to the society, focusing on individual adjustment and life satisfaction. Many years of research failed to show that disengagement is either natural or inevitable. Those who do withdraw do so more often from a lack of opportunities and social or economic constraints than from choice.
Activity Theory
34 In response or reaction to disengagement theory activity, theorists like Havighurst (1957) argue that people adjust best to late life when they maintain high levels of activity and continue the levels of involvement that characterized their middle age (Friedman and Havighurst, 1954). Older people who lead active lives will have higher levels of self- esteem and will generally be more satisfied and/or happier with their lives than those whose lives are less dynamic. Many studies (e.g., Albrecht, 1951; Burgess, 1954; Havighurst, 1957) report strong associations between levels of activity and well-being. This theory, however, places impractical expectations on many older people who may be comfortable living their lives at a more relaxed pace than they did during their middle years.
Continuity Theory
Continuity theory dominated the gerontological literature for many years, especially during the 1980s. The shift from cross-sectional to longitudinal research designs exphasized stability in well-being and personality. Continuity theorists purport to explain why levels of life satisfaction, well-being, and happiness remained stable over time for most people.
Atchley (1989) organized continuity into internal and external continuity. He describes internal continuity as a person’s fundamental structure of ideas, based on memory that persists over time. External continuity focuses on the person’s social and interpersonal surroundings. Atchley asserts that people seek continuity in both external and internal events. Not only do people maintain stability in temperament, identity, and attitudes as they age, but they prefer familiar surroundings and the advantages that come from maintaining lifelong friendships. Thus the maintenance for continuity is advantageous. People desire and pursue continuity.
Research that used longitudinal designs supported many ideas from continuity theory. For example, George and Maddox (1977), as well as Wan and Odell (1983), suggest that
35 most people continuity in well-being and in their social engagements regardless of the changes that they experience as they age, such as retirement.
Other research, for example, Richardson & Kilty (1997), suggests that the key to maintaining continuity lies with a person’s ability to maintain his resources. That is, if people can keep their resources at the same level that they were during midlife, continuity will prevail. But if a person’s resources decrease, as occurs for many older women after retirement, discontinuity will result. In an analysis of older people’s expectations and resources before and after retirement, Richardson and Kilty (1997) found many gender differences in maintenance of financial assets after retirement. Older women, more so than older men, expected to have more lucrative resource during retirement. But many older women found that their resources dissipated unexpectedly when they stopped working upon retirement. They were not prepared for the declines in their standard of loving and newe restricted lifestyle. Ethnicity also affects how easily a person sustains continuity; for example, income levels among blacks decline with age. As we discussed in chapter I, substantial numbers of black elderly are poor. Inequalities that existed earlier in life worsen over time.
SOCIOLOGICAL THEORIES OF AGING
Social Phenomenological Theories of Aging
Social phenomenological theorists (e.g., Gubrium and Holstein, 1999) challenge dominant indeologies in gerontology research that deify positivist approaches. Gubrium and Buckholdt (1977), as well as Reker and Wong (1988), argue that objective measurements y in chewing foods that are rich in proteins such as meat and may concentrateof aging are overvalued and that many gerontologists have ignored subjective perceptions of aging. The meaning attached to growing older remains unclear. The ways that people subjectively experience aging and attach meaning to their lives are fundamental to understanding aging, according to Gubrium and Holstein (1999). The meaning of an event for each individual enlightens practitioners as to what it feels like to age. This view assumes that people differ in their perceptions and interpretations of their
36 experiences. These ideas are especially important for social workers who are interested in clients’ subjective perceptions and objective conditions.
Application of theoretical framework
Aging can be described in sociological terms. From that perspective, the aged interact with society in one of four ways: they can continue to be dynamically involved in the events of the world (activity theory), they can continue with a stable orientation towards society throughout adulthood (continuity theory), they can redefine their roles in the society (role theory) and they can look forward to a withdrawal from society (disengagement).
COMMON DISEASES OF OLD AGE
Health and Common Old Age Diseases When we consider the subject of Health and Common Old Age Diseases, cardiovascular diseases dominate so much so that this entire discussion on aging and disease related aging difficulties would be confined to Cardiovascular Disease in Old People. Cardiovascular disease is the leading cause of Cardiovascular Disease mortality and morbidity today. Coronary heart disease accounts for some 75 per cen.. Old Age Homes Aging refers to the transformation in any organism as time passes by. It encompasses complex processes related to physical, social and psychological changes that occur over time. There are a few forms of aging that develop as time goes by, whereas some gradually decay. Researches are carried out worldwide to bring out the most significant facts about aging. These frontier researches often prove th.. Urological Diseases Urology is an important branch of medicine that deals with the problems relating to the urinary tracts of males and females, besides the reproductive system of males. As a discipline, Urology combines the management of medical and surgical problems along with that of surgical management of cancers. Urological diseases have become quite common in people of both sexes and a lot of research is being ..
37 Chronic Diseases Aging is the most difficult part of an individual's life. There is a distinct set of aging difficulties and chronic diseases which affect the elders. The chronic diseases which cause severe problems in aging are in chronological order, Arthritis, Chronic obstructive pulmonary disease, Depression, Diabetes, Incontinence, Osteoporosis, Pressure sores, Senility (Alzheimer Common diseases symptoms and vaccinations A list of common diseases, their causes and symptoms and the vaccines that can prevent themPolio Serious cases cause paralysis and death. Mild cases cause fever, sore throat, nausea, headaches and stomach aches; may also cause neck and back pain or stiffness. Polio vaccine can prevent this disease. DiphtheriaRespiratory disease spread by coughing and sneezing. Gradual onset of sore throat and low-.. Sleep Disorders An inevitable truth in all of our lives, Aging brings with it a swarm of serious problems and a whole lot of Chronic Diseases. Apart from the more obvious degeneration like skin wrinkling, reduced activity and greying, Sleep Disorders can wreck a huge population of the aged. For most sleep disorders in the aged, behavioral or even psychotherapeutic and pharmacological approaches are not incompati.. Cancer A disease that has the ability to strike people of all ages, which does not even spare the fetuses , is Cancer. With the progression of age, the risk of getting affected by varieties of Cancer has become a common phenomenon. Generally Cancer is defined for diseases where the abnormal cells tend to divide without any control thus invading other tissues as well. The Canc.. Headache and Migraine A migraine headache is defined as a form of vascular headache that is caused by the enlargement of blood vessels and the release of chemicals from nerve fibers that coil around the blood vessels. The headache and migraine leads to the release of chemicals from the nerves. It thus results in inflammation, pain and consequent enlargement of the artery. Occurring in all age groups, headache and migra.. Gastrointestinal Health
38 Do you feel uncomfortable while savoring a tempting recipe and you are frequented with such feelings more than often ,then become a little more conscious than before as you might be just on the verge of encountering Gastrointestinal health problems. These Gastrointestinal health problems in the course of time may become potentially dangerous affecting your heal.. Gall Bladder Diseases Home » Gall Bladder » Diseases Gall Bladder Diseases Gall Bladder Diseases is deeply inclined with the stomach and other parts of human autonomy. Gall Bladder is a pe.. Heart Diseases Home » Heart » Diseases Heart Diseases In the world of work pressure, fast foods, and intense competition in every sphere of life, Heart Diseases are on the rise . Common Ailments The common ailments happen to be the diseases that which we are prone to suffer from in our daily life. They are called common ailments as they occur in common instances to most of the individuals. The most common examples of common ailments are cough and cold, stomach disorder, skin infections, acnes, pimples, body pain, headache and the list goes on. There are some simple steps, which ne.. Infectious diseases Ever since the beginning of mankind, human beings have not been able to escape from suffering injuries and diseases. Various kinds of diseases afflict the human beings at different periods of their life. Many of those diseases could end up being life threatening for the people too. That is why it is important for the people to take good care of their health. There are numerous diseases, the cure o. Epilepsy Epilepsy is derived from the Greek  Health Tips for Old People Old age is usually associated with heart diseases, high blood pressure, diabetes, digestion problems, fragile bones and low perception power. In short, it implies to the loss of youth, vigor, energy and power. You will be happy to know that with a few useful and
39 handy health tips for old people, one can even enjoy a rocking old age! All you need for the same is maintain a certain standard of disci.. Weight Loss and Age Home » Weight Loss- Overview » Weight Loss and Age Weight Loss and Age As people grow old there are a number of disorders which start to show up.. Allergies and Diseases Allergies and Diseases are the principal factors that get into the way of your possessing excellent health and beauty. With the progress of civilization, technology and science with a rapid speed, the world is getting saturated with the huge numbers and varieties of diseases. The more the world is advancing towards civilization, the more number of diseases are breaking out. Some of the alle.. Stomach Diseases Home » Stomach » Diseases Stomach Diseases the Stomach is an important organ in the Human Digestive System. The alimentary canal or the human digestive tract star.. Pancrease Diseases Home » Pancrease » Diseases Pancrease Diseases Pancrease is the important organ of human body. It is located deep within the body just downwards of the stomach. Th.. Intestine Diseases Home » Intestine » Diseases Intestine Diseases The Intestine is a very important organ in the alimentary canal- the digestive tract found in human beings. The Human D.. Aging and Modern Day Medicare With the advancements of medical sciences and technology, many questions pertaining to aging and old age complications have been solved. Many clinics, homes as well as NGOs have stepped forward selflessly to facilitate the living standards of aging individuals worldwide. While aging involves the gradual transformation of individual, mental and psychological capabilities of a human being, it would .. Mouth Diseases
40 Home » Mouth » Diseases Mouth Diseases The mouth is one of the essential organs of the human digestive system. The vital role which the mouth plays has ensured that v.. That Old Feeling That Old Feeling is written by Leslie Dixon. The film is directed by Carl Reiner. Carl Reiner is an American actor, film director, producer, writer and comedian. He has won 9 Emmy Awards in his movie career. That Old Feeling was released in the year 1997. The music of the film is composed by Patrick Williams and the cinematographer of the film is Steve Mason. The film is distributed by the Univers.. Signs and Symptoms of Lungs Diseases Home » Lungs » Signs and Symptoms of Lungs Diseases Signs and Symptoms of Lungs Diseases Though we have classified Lungs Diseases into different types the initial S.. The common cold Runny noses, tired muscles, sore throats and headaches. What's with the common cold and are there any common ways to get rid of it?Soddy, you god doo zpeag ub a liddle. Gan'd ear you dhrough dis bounding in my 'ead. The only way to decipher that is by dislodging that terrible cold from this poor victim's body. But here's a rough translation: Sorry, you got to speak up a little. Can't hear you thr.. Common HairCare Mistakes What are the Hair Care Mistakes We Need to Avoid? Excessive shampooing. Don't wash your hair more than twice a week. If you need to re-do your style, just spray water on the roots and blow-dry. Roughly Handling Wet Hair Do not rush wet hair, no matter what. Wrap a towel around wet hair. When it is fairly dry use your fingers to gently de-tangle the knots in your hair. Divide your. Common Diseases in Old Age Health care in old age Alzheimer's Disease Mental Illnesses Arthritis and Osteoporosis Blood Pressure
41 Heart problems and Heart attack Cancer Diabetes Kidney disease Prostate Enlargement Osteoporosis (Weak bones) Tuberculosis Eyes Diseases Skin Care Fall-related injury in old age Suggestions to remain healthy Health care in old age Millions of senior citizens across the globe are not getting the proper health care they need because governments and the society are not aware enough of the problem. By 2025, there will about 1200 million people aged 65 years according to UN estimates. Failure to address oral health needs today could develop into a costly problem tomorrow. Seven per cent of the 1.1 billion Indian population is today over the age of 60. They too wish to have a better access to health care, look forward to fun, health, dignity, economic independence and a peaceful death. They cannot afford to be ill as sickness is expensive. Some health problem and common ailments that generally affect senior citizens are blood pressure, cardiac problems, diabetes, joint pains, kidney infections, cancer, tuberculosis etc. Once they occur, these diseases may take a long time to heal due to old age. So it is important to get medical checkups regularly to prevent the onset of any of these health conditions. Alzheimer's Disease Alzheimer’s disease is a brain disorder and a slow and gradual disease that begins in the part of the brain that controls the memory. As it spreads to other parts of the brain, it affects a greater number of intellectual, emotional and behavioral abilities. There is no known cause for this disease. As a person grows older, he is at greater risk of developing Alzheimer’s. After 60, the risk is one in 20, but after 80 it is one in five.” No one knows
42 why it happens, but it occurs when cells in the brain start dying. It is degenerative and leads to progressive mental deterioration. The best way to prevent these conditions from occurring is to keep yourself mentally busy. Take part in activities such as dancing, yoga and meditation. Read books, play board games and interact with other people to enhance the quality of your life. Eat a balanced nutritious diet and avoid alcohol and smoking. Consult your doctor about mineral and vitamin supplements that could be of help. In some cases you may be prescribed medicines. Mental Illnesses According to World Health Organization, 25% of the world population is suffering from mental illnesses. But only 40% of these cases are diagnosed and treated. One million annual suicides are the result of these undiagnosed or missed cases. Most common causes for these suicides are depression, dementia, anxiety and Schizophrenia. Senior Citizens are susceptible to a variety of mental illnesses. Depression is the most common of these. Symptoms of depression include- Lack of interest in activities you enjoyed doing. Sadness or unexplained crying spells, jumpiness or irritability, Loss of memory, inability to concentrate, confusion or disorientation, Thoughts of death or suicide, Change in appetite and sleep patterns. Persistent fatigue, lethargy, aches and other unexplainable physical problems, Dementias and Pseudo/dementias. These health issues are characterized by confusion, memory loss and disorientation. Diseases such as Parkinson's and Huntington's as well as high blood pressure and strokes may cause it. When organs such as the heart, lungs, thyroid, pituitary and other glands do not function well, mental processes are affected. Arthritis and Osteoporosis Arthritis simply means ‘inflammation of the joints’. The word rheumatism is even more general, and is used to describe aches and pains in joints, bones and muscles. There are more than 200 types of arthritis and rheumatic disease. The symptoms include pain, swelling and stiffness with limitation of joint movement. Rheumatoid Arthritis: Rheumatoid arthritis (RA) is caused by inflammation of the joint lining in synovial (free moving) joints. It can affect any joint, but is more common in peripheral joints, such as the hands, fingers and toes RA can cause functional disability,
43 significant pain and joint destruction, leading to deformity and premature mortality. It usually affects people between 25 years and 55 years of age. Prevention: Musculo-skeletal diseases are among the most common diseases in old age Approximately 70% of these conditions are minor, self-limiting conditions related to trauma, injuries, sprains, wrong use or over-use of the musculo-skeletal system including sudden unaccustomed physical work and habitual bad posture. Another common cause of ‘rheumatism’ is the aging of the joints called osteoarthritis. Although painful and often disabling, this problem is fortunately not a life threatening serious systemic disease. Osteoarthritis: Osteoarthritis (OA) is the most common form of arthritis. It is a chronic, irreversible and degenerative condition ranging from very mild to very severe. It is characterised by the breakdown of cartilage in joints, which causes affected bones to rub against each other leading to permanent damage. Gout: Gout is caused by an excess of uric acid in the body, which then accumulates in certain joints. It causes sudden attacks of severe pain and tenderness, usually in a single joint and most often in the big toe. The extreme pain of gout is usually accompanied by warmth, redness, and swelling. Osteoporosis is a silent disease in which bones become extremely fragile. If left untreated, it can progress painlessly until a bone breaks. These broken bones, also known as fractures, typically occur in the hip, spine and wrist. They are extremely painful and can take a long time to heal. Prevention Steps: Regular physical exercise and walking, a balanced diet, a healthy life style can prevent this disease. Take your recommended amounts of calcium and vitamin D daily. Participate in regular weight-bearing exercise. Avoid smoking and excessive alcohol. Take a bone density test to check the condition of your bones. Blood Pressure Blood pressure is actually the pressure of blood against the walls of your arteries. Blood pressure is measured in mm Hg. Typical values for a healthy adult human are approximately 120/80. But, if your blood pressure reading is equal to or above 140 over 90 mm Hg, then that means you are suffering from high blood pressure or hypertension. Hypertension has been called the "silent killer" because it usually produces no symptoms. Untreated hypertension increases slowly over the years. Hypertension can cause certain
44 organs (called target organs), including the kidney, eyes, and heart, to deteriorate over time. Malignant hypertension, an emergency condition resulting from untreated primary hypertension, can be lethal. It is important, therefore, for anyone with risk factors to have their blood pressure checked regularly and to make appropriate lifestyle changes. Symptoms: The general symptoms may occur in high blood pressure are: Drowsiness, Confusion, Headache, Nausea, Loss of vision. Prevention Steps: Here are some basic steps that may be followed to check High Blood Pressure or Hypertension: 1. Be physical active by regular exercise, walking, yoga etc. 2 Maintain a healthy body weight 3. Follow a healthy eating plan that emphasizes fruits, vegetables and low fat dairy foods. 4. Avoid alcoholic beverages 4. Quit smoking 5. Have a low salt intake. Heart problems and Heart attack With age the heart and blood vessels become less efficient even in the absence of obvious diseases. The heart tends to get enlarged and the pumping action decreases. The blood vessels become less pliable and elastic. This can result in the swelling of feet, high blood pressure and heart failure. The WHO (World Health Organisation) estimates that in 2006, 3 millions people die of cardiovascular (CVD) disease such as heart disease and stoke in India. In India, heart disease is the single largest cause of death in the country. A heart disease or heart attack occurs when the supply of oxygen-rich blood to the heart is disrupted, usually by a blood clot in one of the coronary arteries that supply the heart with blood. This happens when there is a blockage in one or more coronary arteries. Most heart problems are directly related to unhealthy eating habits, stress and lack of physical exercises. To prevent heart attacks or other heart diseases, it is important to make changes in your lifestyle and live a healthy life. Undergoing medical check-ups regularly is equally vital. Some of the basics of staying free from heart diseases are: Eat a healthy diet to prevent or reduce high blood pressure and blood cholesterol levels, Lose weight if you are overweight, Quit smoking, Reduce your stress, Participate in a physical activity and do healthy exercises, walk, run and practice yoga. Restricting salt consumption to 5gm (one teaspoon in 24 hours) and avoiding salty fried food, pickles and chutneys will help alleviate this problem.
45 Some Specialised heart hospitals in India: All India Institute of Medical Sciences Escorts Heart Institute and Research Centre Apollo Hospitals, Narayana Hrudayalaya Wockhardt Heart Hospitals Sri Jayadeva Institute of Cardiology in Bangalore BM Birla Heart Research Centre The majority of people who suffer a heart attack experience symptoms that are often severe and frightening. Some of the symptoms of a heart attack are: (i) Chest pain that is unrelieved by rest and often spreads or radiates through the upper body to the arms, neck, shoulders or jaw. (ii) Chest-area pressure, discomfort or squeezing sensation. (iii) Shortness of breath or shallow breathing. (iv) Heart palpitations, in which the heartbeat is fast, strong or obviously irregular. (v) Abnormally weak and/or fast pulse. (vi) Fainting or loss of consciousness. (vii) Feeling tired or fatigued, sweating, often heavy and often cold, etc. To know more about Heart Disease Cancer Cancer is a leading cause of death globally: an estimated 7.6 million people died of cancer in 2005 and 84 million people will die in the next 10 years if action is not taken. Cancer is a generic term for a group of more than a hundred diseases that affect different parts of the body. Among elderly men, cancers of the prostrate and colon are the most common while for women it is breast cancer. Other cancers found in geriatric patients are skin, lung, pancreas, bladder, rectum and stomach cancer. A major initiative taken by the Government against Cancer was the launch of the National Cancer Control Programme. This programme aims for primary prevention and early detection of the disease. To improve availability of cancer treatment facilities, various Regional Cancer Centres have been established across the country. Here are some tips that help prevent cancer: 1.Quit smoking, 2. Moderate your diet, Diets high in fruits and vegetables may have a protective effect against many cancers. 3. Regular physical activity and maintain a healthy body weight. 4. Avoid excessive exposure to ionizing radiation. Diabetes Diabetes is a metabolic disorder characterized by high blood sugar. Diabetes is a disease that affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy.
46 The government has established a National Diabetes Control Programme to reign in the disease. The main problem with diabetes is that it cannot be cured, it can only be managed. The common symptoms includes: excessive thirst, excessive urination, infections, extreme hunger, unusual weight loss, extreme fatigue, irritability, nausea, vomiting, sweet smelling breath etc. To control diabetes: Exercise daily: Morning walk, yoga, running and aerobics all help. Make healthy food choices: Choose foods with lower fat, calories and salt. Try fresh vegetables and fresh fruits. Replace soft drinks with fresh juices and water. Eat sensible meals and snacks at regular times throughout the day. Know more about Diabetes Diabetes is one of the leading causes of death and disability. About 65 percent of deaths among those with diabetes are attributed to heart disease and stroke Kidney disease Kidney disease is disorder that affects the functioning of the kidneys. It can be characterized as hereditary, congenital or acquired. Chronic kidney disease is known to affect the elderly and is associated with a high risk of kidney failure, cardiovascular disease and death. In India a large number of people go into terminal kidney failure every year, while millions of others suffer from lesser forms of kidney diseases. Keeping in mind the level of kidney problems in India a voluntary organization called the National Kidney Foundation (India) has been formed by concerned individuals. Prevention of kidney disease:Keep blood pressure under control; Maintain a healthy weight; Maintain healthy levels of fats; Do not smoke or use any tobacco products. Some Specialised Hospitals that treat kidney problems in India are: Wockhardt Hospital and Kidney Institute National Kidney Foundation Indian Renal Foundation. To know more about World Kidney Day
47 Prostate Enlargement Prostate Enlargement is common disease in old age. Generally the prostate gland become enlarged as a man ages. Doctors call this condition benign prostatic hyperplasia (BPH), or benign prostatic hypertrophy. The symptoms of BPH vary, but the most common ones involve changes or problems with urination, such as a hesitant, interrupted, weak stream urgency and leaking or dribbling more frequent urination, especially at night Some men with greatly enlarged glands have little obstruction and few symptoms while others, whose glands are less enlarged, have more blockage and greater problems. Sometimes a man may not know he has any obstruction until he suddenly finds himself unable to urinate at all. This condition, called acute urinary retention, may be triggered by taking over-the-counter cold or allergy medicines. Severe BPH can cause serious problems in long run. Urine retention and strain on the bladder can lead to urinary tract infections, bladder or kidney damage, bladder stones, and incontinence—the inability to control urination. If the bladder is permanently damaged, treatment for BPH may be ineffective. When BPH is found in its earlier stages, there is a lower risk of developing such complications. The diagnosis of BPH requires several tests to help the doctor to identify the problem and decide whether surgery is needed. More information ...Prostate Enlargement Osteoporosis (Weak bones) Osteoporosis with growng age is a condition that means your bones are weak, and you're more likely to break a bone. A broken bone can cause disability, pain, or loss of independence. It can make it harder to do daily activities without help, such as walking. It can also cause severe back pain and deformity. Osteoporosis can happen to any of your bones, but is most common in the hip, wrist, and in your spine or vertebrae. Vertebrae bones support your body to stand and sit upright. There are tests you can get to find out your bone strength, also called bone density. There are also other types of bone strength tests too. If you are age 65 and older, you should get a bone density test. The best way to prevent weak bones is easy--start by
48 building strong ones. The following steps are helpful to stop your bones from becoming weak and brittle. 1. Get enough calcium each day. 2. Get enough vitamin D each day. You can get vitamin D through sunlight and milk. 3. Eat a healthy diet. - like vitamin A, vitamin C, magnesium, and zinc, as well as protein. Milk, fruits and green green leafy vegetables contains most of vitamins. 4. Being active really helps your bones. 5. Don't smoke. Smoking damages your bones and lowers the estrogen in your body. 6. Reduce your chances of falling by making your home safer. Tuberculosis Tuberculosis (TB) is a leading cause of deaths in India. These deaths can be prevented through modern anti-TB treatment such as Directly Observed Treatment Short Term or DOTS. This medication needs to be undertaken for a prescribed duration. The government has established the National Tuberculosis Programme to create the infrastructure for the control of the disease. Precaution to prevent Tuberculosis: Wash your hands frequently, especially after being around people with chronic coughs. Take an annual TB test. They are available at minimal costs at community clinics. Chest X-ray cab be undertaken to detect clinical signs of TB in lungs. Avoid standing close to people when they are coughing. A lot of fresh air should be inhaled to keep lungs healthy. A healthy diet that is rich in vitamins, minerals, calcium, protein and fibre should be consumed. Treatment for Tuberculosis is provided at all government hospitals and health care centres. To know more about World TB Day Eyes Diseases Eye diseases like cataracts and age related macular degeneration, loss of vision etc. are major eye problems in old age. The Government has launched the National Programme for Control of Blindness to treat various eye problems and control blindness.
49
Care to avoid eye problems: While reading or doing concentrated activity, rest your eyes for five to 30- minute intervals. Look away from your work, close your eyes, or simply stare off into space. Blink regularly. Palm your eyes. Sit comfortably, breathe deeply and cover your eyes with the palms of your hands. Protect your eyes from direct sunrays and any kind of dangerous substances. Green Tea: Scientists have discovered that green tea can help prevent glaucoma and other eye diseases. They have found that the healthful substances found in green tea — renowned for their powerful antioxidant and disease-fighting properties — do penetrate into tissues of the eye. The new study has documented how the lens, retina, and other eye tissues absorb these substances. Chi Pui Pang and colleagues pointed out that so-called green tea ‘catechins’ have been among a number of antioxidants thought capable of protecting the eye. Those include vitamin C, vitamin E, lutein, and zeaxanthin. Some Specialised Eye Hospitals in India: AIIMS; Wockhardt Eye Hospital, Mumbai Sankara Nethralaya; Chaithanya Eye Hospital and Research Institute;Guru Nanak Eye Centre Aravind Eye Hospital. Skin Care The skin loses its elasticity with age, becoming dry and wrinkled. Itching and scratching cause mechanical injury and secondary bacterial infection. Apply a small quantity of a mixture of 500ml of coconut oil, 500ml of sesame oil and 100ml of olive oil half an hour before bath. Add a teaspoon of coconut oil to the bath water. Use a moisturising soap. Apply body lotion or baby oil after bath. Doctors recommends foods rich in antioxidants -- green tea, citrus fruits like oranges and pomegranate, spinach, collard greens, broccoli, romaine lettuce and egg yolks -- to combat skin damage from the sun and aging. There have been several studies linking foods rich in antioxidants to protection from the damaging effects of ultraviolet light. Ultraviolet radiation is known to cause production of harmful free radicals, are linked to aging and skin cancer. Fall-related injury in old age In old age changes in vision, hearing, muscle strength, co-ordination and reflexes make older people vulnerable to falls. In addition, diseases of the heart, brain, bones and
50 joints, thyroid and diabetes may affect the balance and gait. Improper lighting, slippery or uneven ground surface, assistive devices, misplaced furniture, pets and footwear are among the most common environmental culprits. With age, one tends to walk slower and loses stability that affects balance. Though surgeries and implants have, to a large extent, overcome the prospect of lifelong disability associated with fall, old age-related falls are considered a common cause of death. The incidence of hip fracture is high in old age. Among older adults, falls are indeed a leading cause of injury-related deaths. These are also the most common cause of non-fatal injuries and hospital admissions for trauma. Thousands of older men and women are disabled, often permanently, due to falls that lead to fractures. The fear of fall can be psychologically debilitating. Every year, thousands of older adults fall and hurt themselves. Falls are one of the main causes of injury and disability in people age 65 or more. People who have suffered a stroke, multiple sclerosis or osteoporosis, are also at risk. However, some precautions can prevent such accidents. One must walk with a stick, avoid uneven surfaces and spreading of small carpets as old people can stumble over them.
Conclusion
The growing number of the aged presents challenges to the larger society. Increasing physical deterioration, the inability or unwillingness of those responsible to provide the care that aged need, the lack of community services to help provide independent livings etc are few of the causes of the care centre of the aged. The aged have greater need for many types of services. The elderly must be allowed to develop the same qualities and capabilities as other people without setting them apart from the rest of the society. This type of attitude will allow the elderly to be themselves.
51 Chapter - 3
RESEARCH METHODOLOGY
Title of the study
A Case study on Karunalayam, Geriatric Care Centre at Pothencode
Research Design:
Case Study-A case study is an in-depth comprehensive study of a person, a social group, an institution or any other social unit.
Pilot study
A Pilot study was conducted by visiting an old age home where the inmates are lived. The information so required from this place was used to determine the feasibility of the study and for the formulation of the interview schedule. Information discussions were held with the old people authorities of the old age home to understand the various dimensions of the present study.
Unit of Study: Karunalayam Pothencode
Sampling: Census survey: a complete coverage
Sources of data: Karunalayam Pothencode
Tools for Data Collection a) Secondary data were collected from journals, books and other documents b) Primary data were collected through the following techniques
Realizing the difficulties that the inmates of Karunalayam may have in reading and writing, the researcher chose interview schedule for data collection
52 .A separate interview schedule was used to gather information from the staff of Karunalayam .Observation was an effective tool to understand the pattern of life at Karunalayam.
Pretest: The pretest was conducted by interview guide and interview scheduled in the pretest the researcher had done little modifications of the interview. The researcher takes a detailed study in Karunalayam
Data collection: may 15 to 25 on 2010
Data Analysis:
The present study is a qualitative one. Data was analyzed on the basis of the objectives.
Chapterisation:
Introducton Literature Review Methodology Data analysis Findings, Suggestions and Conclusion
Limitations of the study
During the present study through all the inmates and staff co-operatives the investigator gave the information, the present study has certain limitations.
As the inmates were afraid that what they disclosed will be passed to the authorities they were not frank and open in their answer.
As the inmates, staffs were quite busy with duties assigned to them; they could not spend much time with me. So the interview was done in a hurry. I had conducted an on the spot interview.
53 Chapter IV
Data analysis
Introduction
Old age is a mental attitude as well as a physical problem. Ageing not only has a biological aspect but also a social aspect in it. Old age is considered as a time of physical and social loss; loss of spouse, children, friends, job, property and physical strength. Some individuals have the innate ability to cope with changing patterns of life while some lack this ability there by facing problems in terms of adjustment in the contemporary situation. Analysis and interpretation of data collected is an important step in any research conclusion and finding in the research is based on these analysis and interpretations.
AGENCY PROFILE
Name of the Agency: Karunalayam
Name of the Place: Pothencode
Name of the director: Dr. Sr. Britto D.M
Name of the Warden: Sr.Princy Xavier D.M
Establishment: 1991
No. of inmates: 30
No.of staff: 8
Area: Pothencode
Village: Ayiroopara
Block: Kazhakoottam
District: Thiruvananthapuram
54 1. To study the History, Objectives and Programmes of Karunalayam a. History of Karunalayam b. Objectives of Karunalayam c. Mile stones of Karunalayam d. Programmes of Karunalayam
a) History of Karunalayam
The main objective of the research is a detailed study of the functions; programmes and various services provided by Karunalayam for this purpose the investigator selected a case study of Karunalayam at Pothencode.
The history of the Congregation of the Daughters of Mary
The Congregation of the ‘Daughters of Mary’ is a missionary congregation founded in Syro - Malankara Catholic Church is the Archdiocese of Thiruvananthapuram. The foundation of over the congregation is built on the teaching and life of Jesus Christ. Its intention is preaching the Good News among the non- Christians and the poor ones.
The congregation was started at Marthadom in 1938, by Rev. Msgr. Joseph Kuzhinjalil and Mother Mary, the Co-founders. The members worked tirelessly to give witness to the presence, love and divine protection of God to our contemporary society, which was poor, helpless and destitutes. Be pure and poor for the kingdom of God is the spirit of the congregation. Sisters in the present day world thought the lowly services make known the good news of the Kingdom of God. Like Jesus who had compassionate love for the poor, we respond to the real need for the people.
The congregational spirit is to share with the poor and the marginalized. Members are available with all the resources for any service is keeping with their life and spirit such as – Visiting the families – Caring the sick, protecting the destitute and social work. The congregation’s social welfare services are opened to all the people, without any discrimination of caste, creed or status.
55 The aged destitutes who experience all the hard ships brought about by oldage and infirmity generally approach us for help. They are deeply wounded by ingratitude, weighted down by depression, stung by disloyalty and steeped in remorse and quilt feeling. In their letter misery we must be compassionate, affectionate and patient. Sisters must be sensitive to this real need of the times, and respond to it positively – first of all by establishing home for the aged, and by accepting them with sisterly warmth, caring them with filial affection and giving them hope and trust in God and goodness. Sisters must also be foresighted to find out practical means and ways to rehabilitate them, which generate in them, seep – respect and bring them to the main stream of social life. So we concentrated on the point of helping the oldagedpeople.
History of Karunalayam
St. Mary’s Province is one of the provinces of Daughters of Mary congregation. It is a society registered under the Travancore Cochin, Literary Scientific and Charitable Societies Registration Act – 1955. Its registration office is at Pongummoodu, in Thiruvananthapuram district. The sisters of the province are the members of the society. They do charitable work in monitory terms and free services all over India, primarily in Kerala – Karunalayam – Home for the Aged at Pothencode is such a free service rendering institution of the congregation. It provides support and protection for aged people and they feel at home.
Pothencode is a remote area about 20 km from the city of Thiruvananthapuram. Most of the people are Muslims who are very poor and illiterate. Majority people are coolie workers having real struggle to meet their needs. Neglected and forsaken old people are a major concern of this area. They don’t have any health case facilities in the locality and have to travel so far to get any sort of health case. Their low wages are not enough to meet the ends of their life. So is such condition, old people are unwanted in the families. Many of them have life long diseases like Diabetes, Blood pressure Arthritis etc. family members find it very difficult to taken case of them .In order to give a new life for the aged in the society. Sisters started an old age home – Karunalayam at Pothencode for the abandoned old people.
56 Karunalayam was started by Daughters of Mary – St. Mary’s province in 1998 as a humble beginning with an intake of fourteen aged women from various places. In a non- formal way it was started in 1991 with five members. The new building Karunalayam – home for the Aged was blessed by Trivandrum Auxiliary Bishop Joshua Mar Ignatius on 24th April 1998. At that time the fourteen inmates were provided homely atmosphere by the authority. Sisters are in charge of them and they accompany them is this physical and spiritual Journey. The family atmosphere of the institution helps the members to lead a happy and orderly life. Sufficient infrastructure facilities and competent personal and helping for the effective works.
By March 2001, thirty-four grannies could avail the service and support in their vulnerable period of life. One of the grannies died peacefully under care. Six of the families of the grannies could be located and the families got ready to accept and take case of them with the guidance and support. Their life in Karunalayam is of great help in adjusting with others and also in leading a more God –oriented and peaceful family life with great concern for the family members. Among this ten of them are bed – ridden. They need continued help and loving care at all time. b) Objectives of karunalayam
1. To ensure overall care & protection for the Aged 2. To improve health status of the Aged 3. To reinstate that the elders are the important for our society 4. To improve their physical, mental, social cultural, emotional and spiritual life. 5. To help them to lead a peaceful and happy life. 6. To prepare them for a peaceful death. c) Mile Stones of development
Karunalayam started in a Non-formal way with five inmates: 1991
1n 1998 the members increased from 5-14
New building constructed for Karunalayam in 1998
57 The number of members increased to 34 in 2001
At present there are 30 inmates
d) Services and programmers.
1. Counseling Service:
The of each Person’s Karunalayam provides counseling twice a month. It helps the elders to free and open talk and share their life experience, and to live peacefully and happily in the present situation. Sisters and professional Counselors give Counseling for the elders. After the counseling, they are free and friendly moving their daily life.
2. Prayer Service
Karunalayam creates a spiritual and peaceful life for the elders. The taste of each person Karunalayam fulfills their special needs. Different prayer sessions like: Rosary, Mediation, Holy mass, Adoration, Personal Prayer, and Inter mediatory prayer etc. The prayer service helps the aged to lead a more happy and peaceful life at Karunalayam.
3. Recreation and entertainment
The inmates get chance to spend time with the nearby school children. Once a year and sometimes frequently the children mingle with them to make them happy by performing various cultural programmes. Thus the inmates forgets their situations and generation gap is filled by being with the small children. Sathsange, cutting joks and wathing T.V are the other entertainments.
58 Manual works done by inmates are:
Cleaning, Vegetable Cuttings, Gardening, plucking srass,helping in kitchen, Serving food,and doing vegetable Gardening.
The other activities given to rehabilitate the inmates are:
Bed making, cattle rearing, poultry farm, kada rearing, rabbit rearing, soap and lotion making, broom making, and love birds rearing. They are engaged in all these interestingly.
4. Karunalayam provides food, shelter and medical facilties for the aged.
Programmes
1. Health Programmes:
Distribution of food items for each Grannie, with the financial help from Help Age India.
Health checkup:- Once in a month Nurses and Doctors come from St. Joseph’s Hospital Anchal. They spend one day with elders to checkup give medicine, and make them creature and act St.Vincent Diabetic Centre Pattom. The first Monday of every month they come and do blood test to the diabetic patients. They give free medicine and do eye check up. Mental treatment: Aged people who are having mental disorders are providing mental treatment. Doctors from Govt. mental hospital Peroorkada, Thiruvananthapuram do come here and help the members. They provide free service and free medicines accordingly.
Cultural programmes:-
Prayer song Welcome speech Single song
59 Speech Group song Sharing Word of God experience Solo Comic Aksharasloga malsaram Vote of thanks.
Celebrations
Onam: - ‘Athapukkalam’- with different colours of natural flowers, There will be pookalamalsaram. All elders wear Kerala dress – put chandanam on forehead. Onapattukal, Onakalligal, Thiruvathira and Onam Sadhya, Competitions: Candle burning, ball passing.
Christmas: - Making crib in front of the house, stars of different colours and designs are hanging by the elders. They all are interested to fill the balloons with air. Decorating crib with serial sets and bulbs. Prayer for Christmas friend. Attending Holy mass, exchanging gifts in a special programme.
Easter: - Preparation of Holy week. Way of the cross every Fridays, celebrating Maundy Thursday, Good Friday etc. Easter egg is special for Easter meal.Easter Mass with special prayers and ceremonies wishing Easter greetings together.
Family day – The special saint of the institution is St. Francis Assisi; October 4th is celebrating as the house day for the inmates. The inmates will decorate the statue of St.Francis Assisi with golden net. Preparation of Holy mass, cultural programmes, outing, grand dinner and watching move are the specialties of family day.
Old age day October 1st: Grand day for elders. Cultural programmes, outing, grand dinner. The able and efficient inmates are participating in the competitions conducted by Help age India at various centers every year. Many of the members secure prizes. The
60 most aged woman is crowend as the Queen and twice that position is secure from Karunalayam.
Birthday celebration of inmates:- Wishing the person with bouque, offer special prayers for the concerned person. Wishing the person, giving gifts grand breakfast will be there. On that day lunch will be very special.
Founder’s day: August 23rd is celebrated as founder’s day and July 30th is celebrated as co-founder’s day. With special prayerful preparation. Classes will be taken by the sisters about founders.
Directors Feast day: It is celebrated in the month of January with special programmes. All the inmates offer prayers. They wish her by cutting cake with song and give present. Inmates are given special meals, new dress and gifts. Day will be enjoyable to all of them. Cultural programmes, Grand dinner, Outreach programme etc.
Awareness classes: -
Programs of the Aged
Cleanliness Importance of water & Electricity Creative activities Memory improving Activities Hygiene Environment & Sanitation programme Group Discussion
Resource persons will come from outside and take classes for elders. It was simple and useful session for the elders.
61 One day in Karunalayam
6.00 Rising
6.00 to 7.30 Brushing, prayer & Holy Mass
7.30 to 8.00 Breakfast, Medicine
8.00 to 9.00 Manual Work
9.00 to 9.30 Reading newspaper, Washing clothes
9.30 to 10.30 Yoga, Tea and T.V watching
10.30 to 11.30 Games
11.30 to12.30 Rosary, Prayer and Adoration
12.30 to 1.30 Lunch, Medicine
1.30 to2.30 Rest
2.30 to 4.00 Creative activities
4.00 to 5.30 Tea, Gardening
5.30 to 6.30 Bathing, Washing
6.30 to 7.30 Prayer, Rosary
7.30 to 8.30 Supper, T.V and Medicine
8.30 to 9.00 Sharing experience
9.00 Go to bed
62
Objective No.2
2) To study the staff, supportive service and Administration of Karunalayam
Services & Administration
To Study the supportive Service and Administration of KarunalayamKarunalayam is known us Home Care for the Aged .Daughters of Mary St. Mary’s province started the Aged home in 1991.
63 Organization Chart
Governing Body (Provincial Superior and Team members)
Local Superior
Director
Warden (Sister in-charge)
Doctors
Geriatric Nurse
Social worker
Dietitian
Home Nurse
Helpers
Watchman
64 Role
Co- ordinating, budgeting, staffing
1. Governing body - planning, organizing, directing, co-ordinating, Staffing, Reporting and Budgeting.They plan the total programmes and organizing it, they select the staff and checking the accounts and evaluate the programmes. Appointment is given by them. All the financial help is given by them. 2. Local superior - She manages the institution. She has an eye over all the functions and activities of Karunalayam. She often visits the inmates and search about them. She is the best person to meet the needs of Local people and public relation, with the help of the Provincial Superior and team members. 3. Director - Director takes the decisions for the aged ones in consultation with the local superior. She directs the staff and support service. Major decisions will be handed over to major superiors- Provincial Superior and Team. 4. Warden sister- is accompanying the inmates always. She provided all the needs of the members. She works in association with the director. She is the co-helper to the members. She gives all facilities like accommodation and other basic needs. 5. Doctors - health check up and prescribe treatment 6. G.N - Take care of and medicines 7. Social worker - counseling and Awareness classes 8. Dietician - provides nutrition’s food for elder 9. Helpers - Here and there helping hands are there to help the members. 10. Home Nurse - bathing, food preparing, and washing, to help daily routines. 11. Watchman - look after over all. He is the best helper in all activities especially outside.
Admission Procedure
Karunalayam prefer to give shelter to the hapless people who have nobody to look after. Most of such cases are being referred from the general hospital destitute ward. In order to get admission the personal fly members have to fill up a prescribed form in which all the details of the proposed inmate is entered. People are given admission without earning for
65 their religious background, currently there are – Hindus & Muslims apart from the Christian women. Although, run by Christmas management preference is for the destitute, suffering, lonely women.
Discharge planning
If any person wishes to go back, Karunalayam in ready to send back the person. The responsible person should make it clear that he can accommodate the client forever under his care.
Objective No.3
2. To understand the methods adopted for resource mobilization
a) Social welfare board provides Rs.500/-per head every month.
a. Help age India gives Rs.400/-for one month. The amount is used for giving special gifts, food items, medical care and pocket money. b. Building construction is under taken by the Congregation of the Daughters of Mary St. Marys Province. c. Mary Matha English Medium School: The salary of those sisters who are working at Mary Matha School. The remuneration is used for the meals and their primary needs. d. Local people, Club and some other benefactors like Bishop, fathers, sisters e. Contribution of Special Celebrations like Jubilee, Birthday, Marriage etc. f. Sidha Medical College Santhigiri: Students spend certain days with the members; they provide meals and conduct cultural programmes and gives presents to them. g. Relatives and friends: The relatives and friends of the inmates sometimes contribute to the institution. This may be either the things, or special meals or money. h. Other sources: Medical shops provide discounted medicines to the inmate patients.
66 To identify the problem faced by Agency
1. Financial problem – This is one of the most crucial problems. 2. Lack of transport facility – This affects the entire community during critical situation. 3. Lack of finance, time, and transport facility negativity affects the agency during the death of the old people. 4. The continuous transfer of the Director, staffs create lot of problems. 5. The lack of proper arrangement of food is another problem because there are many health problems to the inmates.
To identify the problems faced by Inmates
Adjustment with new situations: The person is coming from the family; on the spot they were not ready to accept the new situations Lack of family atmosphere: At family they feel at home but in the new atmosphere they are not able to adjust they take time to manage their own daily activities Lack of freedom: Each person has their own desire and interest. Some time they do not like to obey the rules and regulations of the institution. Food and accommodation Due to their age problems, some find it dissatisfied with their food. Sometimes they want more luxury. Daily routines Many of the members are sometimes bored with the daily routines, though institution does not compel them to do. Lack of love and concern as much they need
Whether the inmates receive, they want more than that their desire to get love and concern is more. It is very difficult to satisfy them as they want.
67 Table – 1
Age wise distribution of the Respondent Sl. No Age No. of Respondents Percentage 1 60-70 17 57% 2 71-80 11 37% 3 81-90 1 3% 4 91-100 1 3% Total 30 100
The total number of members are 30 out of thirty 17 members are in between 60 and 70. There are 11 members who are in between 80 and one has attained 100 years. Health problems are seen in people who have the age in below 80-70. Most problems are diabetes, pressure, sugar and other health problems. It is a wonder that centurion is quite healthy. Worry, tension, repression other disorders are seen in people who are in below 71-80.
Table – 2
Religion Sl. No Religion No. of Respondents Percentage 1 Christian 15 50% 2 Hindu 14 47% 3 Muslim 1 3% Total 30 100
The members are from different religion. Most of them are Christian. We give priority to Christians. But we welcome others also. They co-operate with us we, the sisters have the special call for doing service to the world without considering caste / creed.
68 Table – 3
Education Qualifications Sl. No No. of inmates Percentage 1 1 – 5 20 + 1 70% 2 6 – 7 2 7% 3 8 – 12 2 + 2 + 2 20% 4 Degree – Post 1 3% Total 30 100
Of the 30 members 21 persons are qualified. One of them is teacher. She gets pension. She is a psychiatric patient, so the family is not ready to look after. Her family members are employed. But her mother is no more.
Table – 4
Occupation / Nature of employment Sl. No Name of employer No. of inmates Percentage 1 Govt. Sector - - 2 Private Sector 1 Teacher 3% 3 Unemployed 28 House wife 93% 4 Unorganized 1 coli 3% Total 30 100
Most of them are ready to go to their houses but (the family members) not ready to take them to houses.
69 Table – 5
Marital Status Sl. No Marital of Status No. of inmates Percentage 1 Married 19 63% 2 Unmarried 11 37% 3 Widow - - Total 30 100
Out of 30, 19 are married. Unfortunately most of them are widows. Their children are in abroad so they are not all ready to look after the parents.
Because of financial problem, poverty, 11 members are unmarried. 5 members are spinsters. They feel lonliness.
Table – 6
Visits of children and Grand children Sl. No Visits children & Grand children No. of inmates Percentage 1 Yes 3 10% 2 No 27 90% Total 30 100
Out of 30 members 3 of them get the chance to be visited by the children. They grace money and dresses. 27 members are waiting to see their family members.
70 Table – 7
Visits of friends and Relatives Sl. No Visits of friends and relatives No. of inmates Percentage 1 Yes 4 13% 2 No 26 87% Total 30 100
Four members get the opportunity to be visited by the relatives. 26 members are visited by cousins, sisters, and fathers. They are delighted by the sweets and bakery food.
Table – 8
Reason for care centre Sl. No Reason for care centre No. of inmates Percentage 1 Own desire 2 7% 2 Compulsion of Children 15 50% 3 Compulsion of Relatives 10 33% 4 Other reasons 3 10% Total 30 100
Out of 30, 2 members are staying here willingly. But 25 are staying by compulsion. 2 of them are staying here without marriage. 3 of them are non malayalees. They don’t know the language, country.
71 Table – 9
Reason of compulsion Sl. No Reason for compulsion No. of cases Percentage 1 Children one out of states 4 13% 2 Children one employed 5 17% 3 Quarrel with in lams 2 7% 4 Quaral with relatives 3 10% 5 Other reason 16 53% Total 30 100
Among 30 members 4, members have their children who work abroad. There are many reasons for taking admission in Karunalayam, some of them are not going hand in hand to their relatives. Two of them are not interested by their – daughters in laws.
Table – 10
Suffer from illness Sl. No Suffer from illness No. of inmates Percentage 1 Yes 27 90% 2 No 3 10% Total 30 100
Out of 30 members, 27 are suffering from many diseases. Only 3 members are keeping their health. 100 year old person is not able to hear and devoid of eyesight; but her health has no problem.
72 Table – 11
Entertainment / Recreation Sl. No Entertainment / Recreation No. of inmates Percentage 1 Watching T.V 19 63% 2 News paper 3 10% 3 Prayer 7 23% 4 Other 1 3% Total 30 100
All of them are interested to watch T.V Programmes. 3 of them are taking time for reading news papers. 7 of them are interested to pray. They spend their time by praying rosary and doing meditation. We do not make any compulsion on them to do prayer. As their interest they participate in it.
There is 8 staff in Karunalayam. They joint here, through the relatives and friends. They enjoyed in rendering service to the old people. They are keeping a good relation with the Director. Most of the inmates are good but some of them show irritations. But we make a good relationship with them. They are very sociable with the co-workers by making corrections and asking advice.
We get food from outsiders. Food is good. But sometimes it is not tasty. The atmosphere is calm, quiet and eco-friendly. The calm atmosphere, sociable nature of the co-workers, support and service from the common people helps us to bad (the institution) it in a better way.
73 74
Chapter: V
Finds, Suggestions and Conclusion
Summary
Ageing of global society and its impact on human development is a major concern of the twenty – first century. With the increase in the longevity of life, the aged as a group are not only assuming importance in our social, economic and political framework, but it is felt that they are socially vulnerable and need society’s intimate attention. There is a shift the aged-old institution of family care to the newly evolved concept of the old-age homes catering to the needs and comforts of the elderly persons. The rapid changes in the society both in the economic structure and the psychology of the people calls for a systematic effort for understanding the problems of the aged and meeting the special requirements of the growing number of the aged. This study is to understand the total functioning of Karunalayam, History, Milestons, Services, Programmes, Administration and problems it analyses the various problems faced by the agency, age wise distribution of respondents, educational differentials and marital status, religion etc.
Major findings
1. 57% of the inmates belong to the aged group 60 – 70 2. 70% of the inmates are illiterates 3. 55% of the inmates have home attachments 4. 90% of the persons suffer from illness 5. 73% of the person were institutionalized by the compulsion of the relatives and children 6. The study shows that the 50% inmates are satisfied with the institutional life and most of them prefer to live in the institution than in the family. 7. The study reveals that most of the inmates get co. operation from others 8. The study revels that the institution provide food facilities, accommodation and medical facilities and recreation facility for reducing their tensions and loneliness
75 9. The study shows that the institution have certain difficulties
The absence of the trained staff is a problem getting permanent staff is a problem Another important problem of the Agency is insufficient space grant Absence of sufficient space is also another problem Efficient management also affects the institution
These difficulties affect the proper functioning of the institution.
Areas of further study
A further study of paid and Govt. institutions is better to compare with. Thus short comings can be avoided to a certain extent.
The study could be conducted on the socio-economic status of the inmates which will help to understand the family background of the inmates and there by to have a clear picture on the forces behind the Agency.
Suggestions for improvement
1. Govt. should take active role for the welfare of the Aged through increasing grant to the voluntary organizations
2. Adequate trained staff like Nurse, counselors should be appointed for the effective functioning of the institutions
3. The sisters who are in charge of the institution should spend more time with the inmates for listening their life stories and sorrows. It will relieve them. Give adequate care and protection separate room should be provided for the sick and mentally ill persons.
4. Organize planned and purposeful activities which can constructively engage elderly persons according to their capacities to reduce the problem of loneliness
76 5. Timely medical checkup should be given to the inmates to keep them healthy
6. Create to the younger generations and society the social awareness about the problems of the elderly in India today.
Suggestions
The findings suggest that aged people are distinctly more happy and satisfied in a family. Therefore, every effort should be made to encourage their stay with their families by increasing the social awareness about the problems of the aged. In this context the need for preserving their tradition of joint family could never be more pressing. Though homes for the aged are not, very much suitable for our culture and background. Today homes for the elderly are an inevitable reality. They provide a wide range of services such as residential care, day care, geriatric centers, medical care, recreation and counseling. Moreover the problems of the aged are so complex and so varied that the family itself may not be in a position to resolve the problems of the elderly. Hence some services organized by the community to supplement the arrangements in the family would be helpful for the elderly.
Health and economic problems are already seen in the study a major problem faced by the elderly in India. Hence the end of the hour is to increase medical care, community resources must be utilized for those elderly who can and will like to work. Services like counseling can be given to deal with the social and emotional problems of the aged. Government and voluntary agencies can organize planned and purposeful activities, which can constructively engage the elderly according to their capacities which would reduce the problem of loneliness, boredom and dependency. Lastly regardless of where elderly people live; whether in home or in an institution, what is important is that they feel that they area part of the family and should not be isolated and maintain contact with their children and relatives.
77 Conclusion
From the research findings, it is clear that old age problems are existing in different varieties in our society. Now a days a member of charitable institutions has evolved to help the poor old ones. But the members are increasing at a large rate all over the world. The young generation should understand the present situation. They should get awareness about it. Awareness programmes should be conducted at all levels. Elder people are assets to the society. Their knowledge, their experience, their memories all these should be utilized for the future generations. Therefore chances and situations should be given to the old ones to utilize their abilities and efficiencies. They should share it with the younger ones. To a family, grand parents are a blessing. There are a lot of good things that the younger ones can learn. Life with the grand parents is bliss. Those who reside in old age homes should have all the facilities to feel at home. Their group life should be enjoyable. They could have a satisfied life situation there.
Sharing and caring experiences should help them to be satisfied with what they get from the institution. The period of stay should be an unforgettable experience for them. Thus expecting a favorable atmosphere for the elder people I concluding study.
There is an English Quote-
“Old age may be sweet, if it is made like youth, but youth is burdensome, if it be like old age”
Old men and Children are alike
78