Ageing Disability and Community Health

04|12|2020 to 06|12|2020

           "Old age is not a disease - it is strength and survivorship, triumph over all kinds of vicissitudes and disappointments, trials and illness"

 

          International Day of Persons with Disabilities  is observed  on  the 3rd of December .The theme observed this year is "a day for all " . To commemorate this International Day for Persons with Disabilities. Bharathidasan University, Heritage Centre for Gerontology in association with Prajaahita Foundation organized  three - day webinar on Ageing , Disability, and Community Health .

Role of Creative Aging on
Quality of Life for the 
Elderly

Prof. Manika Walia [(Dean, School of Creativity
Rishihood University)]

Who are the elderly/older adults?

          The UN agreed cut off is 60+ years to refer to the older or elderly persons. Within the elderly population, further classification like the oldest old (normally those 80+) and centenarian (100+) and even super-centenarian (110+) are also made. We define this population as adults aged 55-100, and we view them as whole Intelligent, Creative and Social people. The members of these groups have different tastes and cultural reference points, but they all benefit from tapping into their creative capacity and they have fun doing it.

What are the Common Elderly Issues?

          Getting older can seem daunting—greying hair, wrinkles, forgetting where you parked the car. All jokes aside, aging can bring about unique health issues. It is important to understand the challenges faced by people as they age, and recognize that there are preventive measures that can place yourself (or a loved one) on a path to healthy aging. Common conditions in older age include hearing loss, cataracts, refractive errors, back and neck pain, osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, dementia.

What is Creative Ageing ?

“The key Mantra in Art of Creative Aging is
Respect, Empathize, Encourage, Inspire”

         According to the non-profit organization Lifetime Arts, “Creative aging is the practice of engaging older adults (55+) in participatory, professionally run arts programs with a focus on social engagement and skills mastery.” Creative geing also has much to do with health. Wellness can be achieved in many ways, including using creativity to work the mind and body. Creative aging is designed to provide opportunities for meaningful creative expression through visual, literary, and performing arts workshops. Creative ageing is also about possibilities, adds Pat Spadafore of the Sheridan Centre for Elder Research, and Freeing ourselves of limiting beliefs about ageing and embracing the reality that individuals continue to grow, learn, and contribute to their communities throughout the life journey. Studies show that over 65, people involved in weekly art programs have fewer doctor visits and
take less medication than those without creative outlets. Why do those involved in creative activities or art programs take less medication and have fewer doctors is it? The answer is only because of the creative/problem-solving reinforcements. Humans are social animals and social connections are important. Art and Creativity force the elderly to interact with the outside world.

Examples of Creative Ageing Program

         Arts programs are essential to help older adults remain dynamic members of society and an important part of their communities. Creativity is applied to everything such as Poetry to singing Playing instruments to dancing Painting to Photography Writing a book to learning a new digital skill, Enactment Theatre, and Pottery. Elderly people are an inspiration to the youth by being their role models. It is the elderly people who encourage meaning and a strong sense of purpose to the younger people. At Creative Ageing Cincinnati, for example, classes include ballet and creative movement, chair yoga, recreational group drumming,
dulcimer, and line dancing as well as art programs focusing upon history and culture and the visual arts. Beautiful Minds project cosponsored by DSM Nutritional Products, for example, creative agers are invited to take part in a national photo essay exhibit displaying individuals who are doing “beautiful things” with their minds without letting age be a barrier. It is the ‘making,’ that keeps the heart and mind engaged.

Caring for Caregivers of
adults with Disabilities
 

Dr. M R Rajagopal (Founder & Chairman
Pallium India)

Introduction

          Some health-related situations are more serious in our country than in western countries. The treatments with surgery also include rehabilitation, makes the patient part of the society again whereas in our country the entire burden of taking care of the patient falls on the caregiver. That is, mostly, the burden of young married men falls on the young women who just started living with him. By the end of the operation, the family is financially wiped out. The caregiver faces so many issues.

The Invisible Patients

          The young woman, wife, r middle-aged mother (not necessarily) who takes care of the persons with disabilities through a lot of difficulties. The patient’s suffering is seen at least by some people but nobody recognises what the caregiver goes through. The caregivers go through physical, emotional, social, and spiritual problems. For example, Gomathi who was taking care of five PwDs didn't take care of her own health and died of diabetes. Many caregivers feel that their health
is secondary to that of the person with disability. Their physical problems are ignored. Similarly, their social health also got ignored by society. They have to tolerate the bullying and judgments from the society. They also suffer from financial
issues since they have spent a lot of money for the surgery. Among the physical, social, emotional and spiritual problems, each encroaches on another and causes complex interactions.

Grief

Any loss causes grief. Starting from the time of diagnosis everything is lost, the simple pleasures of life, the dreams, laughter etc. Dr. Elizabeth Kubler, the psychiatrist from the USA, studied grief a lot. She identified 5 stages of grief the most of the people go through namely; Denial(Denying the situation), Anger(on the disease or on the god which come out on the people
around you), Depression(beyond sadness, state of mental illness), Bargaining (involving in weird remedies to come out of this situation) and Acceptance (accepting the situation and prepare to move on). Many go through all these stages though not in the same order. Some might skip one step, some might go back and forth. In a few cases it also might start with acceptance and go in a reverse order. Grief can also be about restoration - worrying about the future.

Solutions

  • The feeling that someone cares

  • Self-support groups

  • Social support groups

  • Respite Care

  • Self-care

Acceptance doesn’t mean that there is no grief. The grief continues, but the person would carry on with life. It’s the process of learning to live with grief. Grief is a tangled ball of so many emotions like anxiety, pain, despair, helplessness, loneliness,
depression, rage, fear etc.

Leveraging Technology for
Empowering Caregivers of 
Elderly

Prachi Deo (Founder-Executive Director,
Nai Disha Resource Centre)

The speaker of the webinar Smt. Prachi Deo commenced the session by giving an introduction about her personal experience in
caregiving. She says that she is the primary caregiver to her brother with Down Syndrome, who is elderly and her mother is elderly and experiencing severe disability. Later on, she added that for the last 5 years she has been working to create a supportive framework for caregivers of persons with Autism, Down Syndrome, and other
developmental disabilities

Disability and ageing

Persons with disabilities do grow older and thus face further barriers in society. In some cases like Down syndrome, adults experience "accelerated ageing" in their 40s and 50s. Symptoms like premature greying of hair, hair loss, and wrinkles can happen. In the case of women, they experience early menopause. Moreover, these people are highly at risk of Alzheimer's disease and common mental health disorders. Our speaker showed a small heart touching video of a father and a son, where the son with down syndrome, and the father is an elder man. Here she points that in most cases, caregivers for eldering with disabilities continue to be their parents (until they are around). At the same time, the caregivers themselves are ageing too!!

Challenges faced by Elderly parents as caregivers

One of the primary challenges faced by elderly parents is their lack of knowledge of technology. They get only limited information on the latest research and discoveries. As the age of caregivers increases, their medical necessities also increase. In such cases of emergency elderly parents alone can't take care of their child. Then the parents need access to
external caretakers and residential homes as they are physically unable to care for their loved ones. Aging parents also have another question in their mind which causes a lot of anxiety. That is, who will take care of their child after them

Challenges Siblings of elderly disabled would face

          Siblings might not be able to comprehend the needs of his/her sibling with disabilities. They also have limited knowledge of the condition. Thus they need more awareness about the physical and mental condition their siblings are going through. Sometimes there needed a striking balance between being a caregiver and giving attention to their own family. There might be a chance of getting less support from their spouse/partner as well.

Creating inclusive Communities for
elderly with  Disabilities

Meenakshi B (Co-founder Equals
CPSJ Chennai)

Smt. Meenakshi introduced the background of ageing and disability. It is estimated that fifteen percent of the population worldwide or
approximate one billion individuals live with one or more disabling conditions. More than forty-six percent of older persons – those aged 60 years and over—have disabilities and more than two hundred and  fifty million older people experience moderate to severe disability. It is a serious issue as the ageing population is increasing and facing
similar impairment like persons with disability. The main focus of the talk is to establish or reiterate the intersectional aspect of ageing
population having disabilities. The big question mark is how we ensure development and participation for the most marginalized group as
we are moving towards the 2030 Agenda and implementing Sustainable Development Goals.

Who are persons with disabilities?

 

          Persons with disabilities are not one specified group. And Convention on Rights of Persons with Disabilities does not define but clarifies the meaning of Persons with Disabilities. According to Article 1 of Convention on Rights of Persons with Disability Act (CRPD),” Persons with disabilities include those who have long-term physical, mental, intellectual or sensory
impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others. Persons with disabilities experience attitudinal, environmental, information and communication, and judicial barriers, which prevents them from participating on an equal basis with others.

Attitudinal barriers

 

          It refers to the assumption of incapacity to work, stigma resulting in neglect, abuse and institutionalization.

Environmental Barriers

          This includes a lack of universal design to buildings, public spaces, transport services, and other utilities such as banking, judicial, health, education.

Information and communication

          These barriers are lack of sign language, tactile interpreters, web content accessibility, plain language information, and so on.

What are the barriers experienced by older persons with disabilities?

After often older persons with disabilities are among the most adversely affected, facing further age barriers in society. The existing inequalities and barriers further intensify with the loss of traditional support systems and the threat of being
institutionalized. The NSSO survey points that at least eighty percent of the population face difficulty in using a public building or a public space. Twenty-eight percent of persons with disabilities have some form of work and even among them
women with disabilities are marginalized. Similarly, under education. So, these are the existing inequalities, so any existing inequalities and barriers further intensify with loss of because as we grow older. In our country, there is no
separate mechanism for providing support services to those. So, only the family members are
supporting people with disabilities. Eventually, that system will also get old or we will lose the system. Once we lose our
parents due to ageing as we grow older, they grow even older so we're losing the traditional support system. In fact, the traditional support system is an additional burden on the woman in the family, which shouldn't be the case, but that is
what we have been using so far.

Physical Disability and health
programs for the Active ageing

Padmini Chennapragada(Founder-Adapted Sports India)

Definition - Active Ageing

          Active ageing is the process of optimizing opportunities for health, participation, and security in order to enhance the quality of life as people age (WHO, 2002). Active ageing activities are not something that starts at the onset of 60 years or after retirement. It is something that should have been started at least two decades before. That is there are different determinants for active ageing which will be
discussed in the later sections.

Factors imparting Active Ageing

          The WHO has identified different factors that influence active ageing. These factors are general factors that influence the lifestyle of any man. Apart from these factors, there are two major terms that influence these factors. Gender and Culture are two umbrella terms that have a major influence on Active ageing. In a country like India where there is a lot of diversity, the challenge we experience could be four times more. That is, how the cultural effects in Telangana will be very different from how it is in Kerala or Tamil Nadu. Thus, while doing this study, if we are able to include these cultural and
gender factors, the programs we do will become more relevant to the community we are serving.

Cultural Factor

          The lifestyle of a person living in an urban area is very different from one who stays in an urban setting. And with that, their health-seeking behaviours also vary. For example, a person living in Nagaland who is used to traversing hilly terrains will have a different physical activity requirement when compared to a person living in plain lands. While talking about culture, it is important to talk about the community that a person belongs to. For example food habits could vary with respect to communities. If the person is coming from a community where people eat foods that are high in fats and carbohydrates, their physical activity needs will be different. The same applies to a community who consume protein rich or deficient food. Another important difference with respect to culture is the diverse ethnicity and diverse attitudes or value systems. How a person perceives these concepts varies from place to place. While working in social work in India, one must think about all these aspects

Gender factors

          One cannot ignore the gender aspect while considering any form of service. One gender related fact to consider is “In India, men are prone to more occupational hazards”. Considering the example of spinal cord injuries we see that the
majority of men have spinal cord injuries and this is mainly because the major cause of spinal cord injuries due to occupational hazards. At the same time, when we talk about caregivers, it is observed that all around the world, women are mostly associated with caregiving responsibilities in a family. This certainly places a definite amount of strain and stress on the mental and physical health of a caregiver. Does this affect their aging as well These are some examples of how gender is a critical factor influencing ageing process. These two factors give us an understanding on how important it is to consider the local culture and gender aspects of beneficiaries while creating and implementing plans and programs within
social work space.