growing old in India

Staying healthy in old age

Your Health
DR GITA MATHAI

India is a young country. Thirty per cent of its population is below the age of 30 and seven per cent over the age of 60. In this scenario, writing about old age may seem inappropriate as it apparently affects only a minority!

This, however, is a fallacy, as the burden of caring for the seven per cent — financially, physically and emotionally — falls on the rest of the population.

Parents grow old, children often live far away and the elders refuse to move in with the next generation as they wish to retain their independence. Responsibility can no longer be relegated to relatives or neighbours. Visits to your parents are a good time to check if they are being able to cope.

Physical appearance provides invaluable clues. Parents should appear clean and well groomed. Failure to bathe, brush teeth or wear clean clothes indicates an inability to keep up with daily routine. This may be due to physical weakness, dementia or just depression.

Adults usually have a fixed routine. If you carefully watch the way parents do things around the house, you might find inexplicable illogical changes in the routine. The house may be dirty and housework neglected. Also, they may be absent-minded, like leaving things on the stove and forgetting about them. These are danger signals indicating that care is required.

Make sure the lighting in the house is bright, especially in hallways and bathrooms. Narrow staircases and slippery front steps are also difficult to navigate. Banisters are essential. Supporting bars need to be embedded near the toilet and bathing areas. Otherwise the chances of accidental falls and fractures are greater.

Good nutrition is essential for immunity (to prevent diseases) and muscle mass (for strength to prevent falls). To monitor nutrition, keep an eye on the weight, the quality of skin, hair and nails. Older adults may suffer from malnutrition even when they can financially afford an adequate diet. They may be unable to shop for the materials required. Cooking may be troublesome, time consuming or they may be physically unable to do it. Medications, illness or a recent hospitalisation may dull taste and reduce the appetite. Diet restrictions (on salt, sugar, oil, fluid and spice) owing to diseases may make the food unappetising and inadvertently limit intake. Social isolation and depression can also lead to people eating less.

If necessary, meals (at least once a day) can be delivered from outside.

We all have memory lapses and these are greater and more frequent with increasing age. Glasses and keys may be constantly misplaced. Memory loss is abnormal if it extends to names of close relatives (children, grandchildren, nieces and nephews), the way to the neighbourhood shop or dosages of regular medications. At that point, medical evaluation is required.

Lifestyle and chronic diseases occur with ageing. It is important that all medical details and prescriptions be neatly filed chronologically. This should then be placed in an accessible place. Medical check ups and visits to the doctor should be scheduled regularly. Medical containers should be neatly labelled. If tablets are in strips, the person should be able to distinguish one medicine from another. Some look very alike (calcium tablets and metformin) and it is possible to make disastrous, life-threatening mistakes.

Hearing and eyesight should be checked regularly and timely corrective measures taken. Hearing loss and partial loss of eyesight leads to dependency and feelings of social isolation. Cataract surgery and hearing aids (if required) often are lifesavers.

Sleep disturbances are common in older adults. In some it may be because of Alzheimer’s, when the sleep-wake cycle is disturbed , leading to daytime drowsiness and night-time restlessness. In many it may be because of medications, snoring (obstructive sleep apnea) or restless legs or just depression.

Good sleep can be promoted with

Exposure to a few hours of bright sunlight in the morning

Not taking caffeine (tea or coffee) after 1pm.

Adjusting medication with the help of the doctor so that any tablets with a stimulatory effect are taken in the morning.

Avoid sleeping tablets as they are habit forming and cause confusion.

Daytime sleep should be avoided at all costs. No one can sleep for more than 6-7 hours a day. If this quota is used up during the day, night sleep will be affected.

Medically treat any diseases that might interfere with restful sleep.

At the age of 60, elders need a dose of pneumococcal vaccine to prevent the development of silent and often fatal pneumococcal pneumonia.

Physical activity for at least an hour a day should be encouraged. Walking will help with appetite, lifestyle diseases, balance co-ordination, depression, dementia and sleep disturbances. It will also entail some social activity as they will meet other walkers.

A little extra effort will pay off in the long run to make old age hassle free for everyone, both the elderly and the young adult.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in