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August 20, 2019 Tuesday 11:59:38 AM IST

E-OLD is Golden

Ageing is a series of processes that begin with life and continue throughout the life cycle. It is a period of physical and social loss - of spouse, friends, job, property and physical appearance. Ageing is often considered a state of mind.  Geriatrics refers to medical care for older adults, an age group that is not easy to define precisely.

‘Older’ is preferred to ‘elderly,’ but both are equally inaccurate; >65 is the age often used, but most people do not need geriatric expertise in their care until age 70, 75, or even 80. The UN agreed cut-off is 60+ years to refer to the older or elderly persons. Within the elderly population, further classification like oldest old (normally those 80+) and centenarian (100+) and even super-centenarian (110+) are also made.

Ageing brings in many physical and psychological changes but definitely not just a biological function or a matter of physiological changes; it is also a product of the social norms and expectations that apply to each stage of life.

Old-age manifests itself through external changes in our body systems.  Physical strength leaves us resulting in general weakness and physical and mental infirmity. Retirement causes a significant financial deficiency as well, adjusting to which requires development of new coping skills and they now feel the need of physical, emotional and financial support from their children.


 Generation gap

 It refers to differences between generations that cause conflict and complicate communication, creating a gap. "Generation gap can be a frustrating lack of communication between young and old or a useful stretch of time that separates cultures within a society, allowing them to develop their own character." (WW Safire).

Although there have always been differences between the generations, the drastic differences that the term implies were not much in evidence until twentieth century. Before that time, society was not very mobile, with younger people living close by in extended families and working in family properties or businesses or pursuing similar occupations.  With the advent of television and movies, young people were exposed to cultural influences alien to their own families and cultures.

The advent of mobile phones and smart phones has revolutionised the way people are living. It has often accentuated generation gap since older people are less capable to catch up with modern technology. In this world of internet overuse and technological advances, when the children make themselves busy, the interaction time gets narrowed down due to which the elders are often left unattended. On the other hand, it should be noted that new technologies are helping the rural elderly stay in touch with their children who can even reach home more easily than in the past. It is also observed that the elderly who got training in using smart phones and social media could manage the feelings by making themselves busy in the web world.


Indian scenario

The ever-increasing elderly population of India which is expected to reach 12% of the population by 2025, poses social and financial challenges. Population ageing poses certain challenges, especially for a country like India. Ageing among female population results in neglect experienced by women, exacerbated often by widowhood and complete dependence on others. A second challenge would be ruralisation of elderly (71 per cent of the elderly live in rural India, 2011 census) which interferes with income security and quality health care. A third concern is the migration of youngsters especially from rural areas, which can have both positive and negative impact on the elderly.

 Looking after our parents is a similar responsibility like taking care of our children in terms of our lifecycle. Deterioration of the condition of elderly due to lack of income, disagreement amongst family members regarding responsibility for parents’ care, limited income of children and maltreatment had made their lives troublesome. Factors such as fewer children in each family, increased employment opportunities for women who were traditionally taking care of the old in India, rapid urbanization, rise in the number of nuclear families invite more focus on geriatric issues. Migration of children seeking jobs, changing societal values and certain negative stereotypes also affect these age group. Complete financial dependence on the family, reduced respect received and excessive emotional dependence on children have destroyed the peace of their lives, as narrated by a few of them.

 Elderly care differs greatly among different countries and there are tremendous cultural and political variations in the way in which ageing is viewed. However, in our part of the world also, the tradition that the elderly would live with their children and grandchildren, rather than entering a care home, is changing. The traditional Indian society, with a joint family system, had safeguarded the social and economic security of the elderly people; it had also laid stress on respecting and caring for the elderly.


With the emerging idea of nuclear family set-ups in recent years, the elderly people have been exposed to emotional, physical and financial insecurity. Old, vulnerable and weak persons, dependent on others for their daily needs, are routinely abused and exploited worldwide. The perpetrators are generally family members, caregivers or trusted others.  Those parents who are educated and who have a healthy relationship with the children than having an emotional dependence, could manage the situation a little better, by knowing that they have now grown up to lead an independent life of their own. Having a definite monthly income, access to health care system and being part of a healthy community living further adds to the confidence. Being aware of the services provided through different sources like Help Age India may also be useful.

Whatever be the case, care of the elderly should be considered as the duty of the next generation which should be carried out in an appropriately dignified way. It should be remembered that what you are now is because of them! You should pay back for that, also to get it back from the ones you are fostering now. The trend set now in social media by the Face app can be considered as a healthy approach of younger generation towards the ageing process which should be reflected in the way they care for their elders.

United Nations principles for care of older persons 

The following principles have been recommended:


1.      Older persons should be able to live in environments that are safe and adaptable to personal preferences and changing capacities.

2.    Older persons should be able to reside at home as long as possible. Laws and policies cannot teach us family values and respect for elders. Thus, parents have a major role to play in fostering respect for elders at a tender age.

3.    Older persons should be able to enjoy human rights and fundamental freedom when residing in any shelter, care or treatment facility, including full respect for their dignity, beliefs, needs and privacy and for the right to make decisions about their care and the quality of their lives.

4.    Older persons should be able to live in dignity and security and be free of exploitation and physical or mental abuse.


5.     Older persons should be treated fairly regardless of age, gender, racial or ethnic background, disability or other status, and be valued independently of their economic contribution.

6.    Older persons should have access to the educational, cultural, spiritual and recreational resources of society.

Modern society

 We are living in an era of information exchange and communication. Therefore, people assume that it is easier nowadays for individuals to maintain their social networks. We use internet technologies and mobile phones on a daily basis to keep in touch with our loved ones. However, the situation looks different when we think about elderly people. It is not that easy for them to introduce technology in their lives. That is why the question stays open: is it easy for older people to stay in touch with their families and friends in contemporary world? And what about generational differences?  Should this lead to serious conflicts? The answer is No.


The largest areas of difference between the young and the old pertain to technology and music. The issues are much less emotionally charged than political issues! In our experience, most older people are proud of the younger generation’s expertise in handling modern technology. It is not viewed as a problem. It is well known that each generation likes its own style of music. As they grow older, people feel nostalgic about old songs and music which may stir up emotions.

 Conclusion

The moot question is, are older people today better off than people of previous generations? Most people will have a positive answer to this. People now live longer; they have better health, and the development of medical and social care allows them stay physically, mentally, and socially active much longer in comparison to generations of their parents and grandparents. However, if you look deeper into the details, it will be clear that ageing in contemporary society means also facing up many challenges: many teenagers are not ready to spend their time and money to help elderly parents; older people also face gender and age inequality when it comes to the economic well-being.


On the positive side, older people have many opportunities today for social connections compared to their previous generations. If used effectively, such social networking will foster well-being. In the case of older people, our efforts should be interdisciplinary and should include psychological, medical, cultural and financial aspects of their lives.


Prof Roy Abraham Kallivayalil & Dr Soumya P Thomas

*Prof. Roy Abraham Kallivayalil MD,DPM
Secretary General, World Psychiatric Association   
Professor & Head, Dept of Psychiatry

Pushpagiri Institute of Medical Sciences,  

Tiruvalla, Kerala- 689 101, India

                   &

**Dr Soumya P Thomas MD

Senior Resident

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