GERIATRIC CARE – A RAY OF HOPE THROUGH AYURVEDA

Ageing is a physiological phenomenon which results from the evolutionary changes occurring in the mind-body system. Population ageing is an inevitable and irreversible process. The elderly population is projected to rise to 12 perc by 2025 due to the undergoing demographic transition in India. With the advancement in medical science and increased life expectancy, the elderly population (60 years and above) is growing faster than the young population globally. They are facing so many problems which may affect their quality of life.

Seven Common Geriatric Syndromes are,

1. Bladder control problems- More than half of older adults suffer from incontinence, according to the CDC
2. Sleep problems. Roughly half of the Elders are reported with difficulty in sleeping.
3. Delirium
4. Dementia
5. Falls.
6. Osteoporosis.
7. Weight loss

We can divide the common geriatric problems under 4 headings.

• Physical problems.
• Cognitive problems.
• Emotional problems.
• Social problems

1. Physical problems

In India, the elderly suffers from the dual burden of communicable and non-communicable diseases. Impairment of special sensory functions like vision and hearing and other degenerative diseases are also common morbidities. Geriatric populations are more affected with non-communicable diseases like diabetes mellitus, hypertension, heart diseases, kidney diseases, chronic obstructive pulmonary diseases (COPD), cancer etc. Recoveries are usually slower, and complications arise rapidly in older people compared to adults. Poor geographical access and high cost of treatment are leading to poor utilization of health care.

2. Cognitive problems

Cognitive impairment is often multi-factorial, which means the difficulties with memory, thinking, or other brain processes are often due to more than one cause. Common causes include medication side effects (the use of tranquilizers, sedatives et.), metabolic imbalances ( like blood sodium, calcium levels), hormonal imbalances, vitamin and nutrient deficiencies, infections, delirium, psychiatric illness ( depression, anxiety, bipolar disorder, schizophrenia) substance abuse and damage to brain neurons due to injury and degeneration (Alzheimer’s disease, Parkinson’s disease etc.) which can eventually lead to dementia.

3. Emotional problems

Loneliness, sense of helplessness, extremely critical and suspicious behaviour, stubbornness, selective memory, anger, grief are some examples. It also includes some cognitive problems like depression, anxiety etc.

4. Socio-economic problems

The rapid urbanization and societal modernization may process a breakdown in the family values and the framework of family support, economic insecurity, social isolation, and elderly abuse leading to a host of psychological illnesses. In addition, widows are prone to face social stigma. The socio-economic problems of the elderly are aggravated by the factors like lack of social security and inadequate facilities for health care and rehabilitation. Many surveys have shown that retired elderly people are challenged with the problems of financial insecurity and loneliness. Death of the partner also causes loneliness and insecure feeling.

The elderly is also prone to abuse in their families or in institutional settings. This includes physical abuse (infliction of pain or injury), psychological or emotional abuse (infliction of mental anguish and illegal exploitation), and sexual abuse.

The Current scenario – Covid 19 related problems Apart from the above, this covid 19 scenario also poses large impacts on elderly population. Covid 19 leads to physical and mental impacts to everyone, especially in the elderly population. It caused neurological and mental complications like delirium, stroke, agitation etc and so many other symptoms at the multisystem level. Older adults are known to experience loneliness, age discrimination and excessive worry. Decreased social life and fewer in–person social interaction is occasionally associated with reduced quality of life, increased depression, sleep disorders etc.

Solutions

Family level: All the family members should aware of these problems of the elderly and have to give the proper care. Parents have a major role to play toward fostering respect for elders from childhood. They should teach the youngsters about family values and respect to the elders.

Government level: Recently, the Government of India has taken significant decisions towards securing the rights of the elderly. In 2007, Indian parliament passed a bill known as Maintenance and Welfare of Parents and Senior Citizens Act, National Program for the Health Care of Elderly in 2011 and The National Policy on Senior Citizens in 2011, recognizes senior citizens as a valuable resource of the country. It aims at providing socio-economic support through income generating activities, insurance, and pension schemes, and promoting care of senior citizens within the family. There are hundreds of oldage homes, day-care centres and mobile Medicare units that provide care to the elderly population.

Geriatric care through Ayurveda

Ayurveda has got the potential for prevention of diseases by promotion of health and management of diseases occurring in old age. The branch called Rasayana deals with the problems related to ageing and methods to counter the same. It’s unique therapeutic methodology delays ageing and minimizes the intensity of problems occurring in this degenerative phase of life by influencing metabolic and immunological status. These types of interventions are significant in the context of geriatric care. Rasayana deals with the science of nutrition, geriatric care, and rejuvenation. It is the answer to the problem of healthful longevity. Rasayana includes a specialized regimen which includes rejuvenating remedies or drugs, dietetics, an overall healthy lifestyle and positive psychosocial conduct. It influences the fundamental aspects of the body viz. dhatus, agni and srotas thereby enriches the nutritional values, improves digestion, absorption and metabolism and enhances micro-circulation and tissue perfusion. It results in healthy tissue longevity, immunity, vitality, happiness, and improved intellect etc. Rasayana drugs are likely to be nutrient tonics, antioxidants, anti-stress, adapt genic and immuno-modulators. Amalaki, ashwagandha, Brahmi, sankhupushpi, chyavanaprasa are some Rasayana drugs.

In geriatric care, selective panchakarma therapy like Abhyanga, Sarvanga dhara, sweda, Shirodhara, Brimhana vasti, Matra vasti etc. may be advised to encounter the degenerative processes. It ensures the preventive, promotive and rehabilitative health purposes, and management of various systemic diseases.

Geriatric yoga provides good balance, bloodstream and tissue liveliness thanks to the enhanced flexibility and core stabilization. It reduces sympathetic activity with relaxing techniques. Pain, fatigue, depression, and stress decrease with a relaxing response. Memory becomes retentive.

Diet is also having an important role. Vegetables, dairy products, fish, legumes, nuts, eggs, etc. should be included in the diet. Avoid too much salt, fat, and heavy protein in the diet. Meals should be light, freshly prepared, easily digestible and nourishing. Along with a nutritious diet, regular exercise, yoga, meditation, prayer, motivational reading etc. should also be included in daily life.

Ageing is a process of physical, mental, and social change in multi-dimensional aspects. They are facing challenges at all these aspects. Care from the families and governmental supports are necessary to improve their quality of life. So geriatric health care must be made a part of the primary health care services. It must be remembered that complete health care to the elderly is possible only by the comprehensive and multidisciplinary approach. Ayurveda presents a comprehensive and holistic approach towards the management of most of the problems prevalent in the elderly through its pharmacological and non-pharmacological measures.