Sunday, September 28, 2008

Care for the Elders

The World population of the elderly is increasing and by the year 2050, adults older than 65 years will comprise 1/5th of the global population. In India 3.8% of the population are older than 65 years of age. According to an estimate the likely number of elderly people in India by 2016 will be around 113 million.
Ageing is a biological phenomenon. Every one of us grows old over a period of time. Ageing brings along with it several disabilities and physiological deterioration. This is the time of life when the elders need our support and understanding and it is the duty and the responsibility of the young and the able bodied to look after them. With the gradual demise of the joint family system there are signs of change in this tradition and it is visible in the increase in the numbers of the elderly who are staying in old age homes with nobody to care or provide support and succor to them.
We will be failing in our duty if we ignore this part of our commitment and duty. Youth is not permanent and every passing day adds to our ageing. What we give today we beget tomorrow.
As Shankaracharya says in the Bhajagovindam:
“Maa kuru dhana Jana youvana garvam,,Harathi nimeshath kaala sarvam
Maayamayamidam akhilam hithwa brahma padam twam pravisha vidithwa”
Meaning: Do not be arrogant or proud of your materialistic possessions, about the fact that you have lot of people to serve you and about your youth because these can be taken away in a very short period of time. Leaving all these illusionary possessions, take the path of salvation by complete surrender to God.
If we have to serve our elders we need to have an understanding of their needs and difficulties. This will first of all give us a positive frame of mind while doing things for them. Through this article we shall try to learn and understand a few things that the elders need and the physiology behind the changes in their physical and mental makeup.
With ageing comes lot of changes in the body. We lose our teeth, hair, our vision and hearing goes down, we lose our flexibility, the bones and joints become weak, the skin dries and wrinkles, the brain is unable to retain its memory and many more changes.
Let us look at some of the illnesses that affect the elderly and how Ayurveda can be of help to them.
Ayurveda advocates the practice of some simple procedures such as Abhyanga and Kavala for prevention and treatment of diseases occurring in the elderly. Let us look at them in some detail:
Abhyanga and its benefits:
The process of applying oil over the body is known as Abhyanga. Ayurveda advises the usage of sesame oil for the purpose of Abhyanga. Regular practice of oil application over the body will help prevent or slow down the process of ageing, reduce the aggravation of Vata dosha in the body and also help relieve fatigue.
Vata is one of the three doshas present in the body which when in balance are responsible for health of the body. Aggravation of Vatha dosha leads to different diseases major among which are joint diseases, weakening of bones (osteoporosis or softening of bones), paralysis, constipation, dry skin etc.
Regular and simple application of oil all over the body will help i) improve blood circulation, prevent all the above said diseases ii) bring flexibility to the joints iii) strengthen the bones iv) nourish the skin and keep it soft.

How to do Abhyanga?
The tila taila should be slightly warmed (lukewarm) before applying over the skin and concentrate the massage around the joints, over the spine (neck, lower back). What we give comes back to us as the fruit of our action. The oil should also be applied over the scalp (Shira), hands (Hastha) and feet (Pada). Leave it for 30 minutes and complete the process by taking bath in hot water. Use besan or any bath powder available in the market to remove the oil from the skin.
Medicated oils are also available in the market and the commonly prescribed ones are ksheerabala taila and Mahanarayana taila.

Kavala (Gargle with oil):
The teeth and gums weaken with age. Eating becomes a painful process and the elderly have to avoid eating hard objects because of their weak teeth and gums. To prevent this Ayurveda advocates the practice of kavala or gargle. The oil to be used here is sesame oil.
Procedure, duration and benefits:
10ml(2 tsp) of sesame oil  is taken into the mouth and gargled for 10 minutes. The oil is spit out after that followed by gargling with warm water. This process helps strengthen the teeth, gums, jaws and improves the sense of taste.
Arimedadi or Irimedadi taila is medicated oil used in Ayurveda for gargle. This is very useful as a gargle in diseases conditions of the teeth and gums. This is also used for prevention of the diseases of oral diseases.

Some of the most common health problems among the elderly and Ayurvedic solutions to them:
Dry skin and wrinkling
Having regular oil bath is the best preventive and curative procedure in this condition. Plain sesame oil or medicated oils such as Mahanarayana taila can be used.
This is the most common and troubling complaint seen in the elderly. Elimination of waste after digestion is very much essential for maintenance of proper health. The elderly suffer more from this problem because i) the mucosal secretions dry up inside the intestines ii)the weakening  or sluggishness of peristaltic movements. Ayurveda provides easy and gentle solution to this problem and the most commonly advocated medication is castor oil based preparations. Gandharvahasthadi eranda taila, Sukumara eranda are some of the castor oil based medicines which are widely used. Triphala choorna is also useful in this condition. The dose and choice of the medicine varies from person to person.
The best ways to avoid or prevent constipation are:
  1. Increase fibre intake in the form of good quantity of fruits and vegetables
  2. Drink adequate quantity of water
  3. Drink a glassful of milk at bedtime and a glass of warm water early in the morning
  4. Simple exercises, yogasana and walk also help
Osteoporosis is the gradual loss of minerals from the bones leading to reduced strength and softening of bones. Bones are the basic support structure of the body. The onset of osteoporosis starts from the age of 40-45 among women, the period when they go into menopause and in males the changes start after 45 years. The most common symptom of this problem is backache and arthritis. When ignored, this can lead to severe problems such as hip joint fracture.
Prevention and treatment:
Natural calcium supplements such as Shankha and Pravala bhasamas are useful in this condition. Regular oil is a wonderful preventive practice to reverse the condition of osteoporosis. Regular oil bath keeps the skin healthy and thereby helps in Vitamin D synthesis with the help of sunlight. Vitamin D is essential for the absorption of calcium from the intestines.
The use of milk and small quantity of cow ghee in the diet is very much helpful. These days people start avoiding ghee after they cross 40 years citing the reason that it is cholesterol enriching. Anything in excess is harmful but the same taken in moderation is nectar. Ghee is a resource of essential fatty acids and for vegetarians it is a must. Ghee is a nutritive tonic to the brain, acts as a lubricant in the intestines, helps stimulate the digestive fire, is good for eyes and the list of its uses are endless. Suffice to say that pure cow ghee should not be avoided at any cost by the elderly.
This problem is due to wear and tear of the joints and the joints most commonly affected are knee, hip and the lower back. Pain and difficulty in movements are the major symptoms of this problem and in later stages the joints appear swollen. Early diagnosis and treatment is the best way to address this illness which affects majority of the elderly population. The limp in the gait, preventive collar  around the neck and the lumbosacral belt around the spine are tell tale signs of degeneration in the skeletal system Apart from these external support system there are good medicines in Ayurveda to treat this problem.
Externally the use of Mahanarayana taila, Ksheerabala taila, Balaashwagandhadhi taila for massage over the affected joints gives good relief from the pain and swelling.
Guggul based preparations and kseerabala (internal )are some of the medicines used in the system to treat this problem.
Excessive use of painkillers should be avoided at this age because of the risk of gastritis and ulcers. If the pain is intolerable painkillers should be used under the dcotor’s supervision and not from over the counter (directly buying medicines from the medical shop based on the pharmacist’s advice).
Ayurveda is the Science of life with eight major branches. One of these eight branches is the Rasayana chikitsa - the anti ageing treatment arm of Ayurveda. There are wonderful preventive and therapeutic approaches advised in this branch of Ayurveda to help the aged lead a better quality of life. The best time to start taking rasayana therapy is the middle age i.e. in the mid forties. This will prevent and reduce the severity of the effects of ageing.

Table showing some common problems associated with ageing and their preventive treatments:

Loss of memory or deficient memory

Single drugs: Brahmi, shankapushpi, kushmanda

Formulations: Brahmi ghrtha, Saraswatharitishta

Vision difficulties 

Saptamrutha Lauha, Tiphala Ghrtha

Reduced libido

Vaanari Gutika, Ashwagandha Rasayana, Ashwagandha Choorna


Swadishta Virechana Choorna, Abhayarishta, Eranda Taila

Arthritis, painful joints

External use of medicated oils such as Mahanarayana Taila

Internal use of Guggulu based medicines

Tremors, unstable gait

Powder of Mucuna pruriens, Vidaryadi Kashayam and ghrtham

Hair loss, graying of hair

External use  of medicated oils such as Bhrngaraja Taila and Neelabhrngaraja Taila

Internal use of pills of Saptamrutha Lauha

General debility and loss of stamina

Vidaryadi Kwath, Chyavanaprash, Kushmanda Rasyana

Old age is the time when they need:
  1. Understanding and empathy
  2. Emotional support
  3. Somebody to talk with them, even for a few minutes will make a difference
  4. A sense of security
  5. A sense of self respect and that an assurance that they still matter
Apart from giving them medical care they also need emotional support. You can make a difference to their lives by:
  1.  Sparing some of your valuable time to be with them and pep them up with some news, jokes etc
  2.  Playing a game of chess or whatever they know 
  3.  Provide them with some regular reading material such as papers, books, magazines etc.
  4.  If they are not able to read because of poor vision you can read a story or a news item 
  5.  Accompanying them occasionally for a walk, encourage them to  make friends with elderly people in the neighborhood so that they have some company
  6.  Encourage your children to talk and play with them 
  7.  If an elderly member is ill or bedridden explain to the whole family including the children and servants about their condition and train them to attend to their needs. A spittoon near the bed, a jug of water at hand will be of help. Ensure cleanliness and hygiene in the room as well as adequate light and air.
We need the elders blessings to grow and the Nation will grow only when its elderly are given respect and are treated with understanding. It is not enough to just reserve a seat in the bus to the elderly. We can show our compassion by allowing them to get inside the bus easily, leaving our seat for them if we are seated, help them get down by helping them with their luggage. This is just an example because examples make understanding easier and are more convincing.

Changes do not happen in a day. Small changes in our behavior gradually build up and one day without our being aware of it, compassion will become an inseparable part of us. To initiate that process we have to start somewhere. What better place than our own home to start the process of change?

Maatrudevobahava Pithrudevobhava

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