Attending to Ageing and its process: Understanding the journey of growing older 

Ageing is the progressive process of getting old. This takes place over the entire lifespan. People who are 65 and above are considered as elderly people. The pace at which ageing occurs is much faster while considering the past. Let’s see how.  

During 2020, there were 1 billion people who aged 60 years. By 2030, it is expected to reach 1.4 billion. While we’re near the reach of 2050, the world’s population aged 60 years and older will double into 2.1 billion. Researchers also predict that during 2050, nearly two-third  of the world’s population over 60 years will live in low- & middle-income countries.  

Population ageing is the phenomenon where the rapid shift takes place in the distribution of  a country’s population towards elderly people. 

Why talking about ageing is considered as important? 

Elderly people are often seen dependent on others and considered as burden to society. As the elderly population increases, it’s an alarming situation that we should need to know the challenges and struggles faced by the elderly to take care of them. Everyone should feel responsible to take care for the elderly. Let’s learn about physical, psychological and social factors that impact ageing. That’s help us  to understand the needs of the elderly. 

Major kinds of ageing  

• Primary ageing: The primary ageing is a gradual process and inevitable part of life that starts early in life and  continues till the end of life.  
• Secondary ageing: It occurs due to the factors such as disease, abuse and disuse that is under the control of the individual. 

Health conditions that affect the elderly population 

• Arthritis 
• Sensory impairments like hearing loss, visual impairment 
• Cataracts 
• Diabetes 
• Depression 
• Memory problems like dementia 

Eye and ear impairment should be taken care off. Because after some point of time, the brain loses to get stimulation and work slowly.

Types of Ageing 

1. Chronological Aging: It is the number of years an individual has been alive from the time of birth.
2. Biological Aging: It is the act of decline in physiological ability of a person to meet demands that occurs over time.The core principle is that ageing occurs as a result of damage to cells & tissues in the  body. 
3. Social Ageing: It is the process of transition in an elderly individual on the aspects of their roles and relationship due to ageing. 
4. Psychological ageing: It is the change that occur in one’s mental health and emotional well-being due to ageing. 

Read More: Ageing Paradigms in India: Navigating Challenges, Envisioning Futures

Stages of Ageing 

1. Independence / Self-Sufficiency 

At this early stage of ageing, the elderly can function independently without seeking help from the others. They’re more self-reliant. At this point, the family members should encourage their loved one to continue with their healthy habits and that would be helpful  to maintain their independency. They should eat well, do regular exercise and socialize with friends. It’s difficult for people at retirement phase to realign their work, they may feel loss of productivity or loss of sense of identity and purpose. 

2. Interdependence 

During this stage, individuals may start struggling with everyday duties. The risk for decrease in quality of life is high, if the individual doesn’t receive proper support. A slight cognitive decline may be expected. There is also high risk for depression, anxiety and stress during this phase. There can be loss of independence and fear about future may arise. 

3. Dependence 

At this phase of dependence, the individual’s age-related changes are more obvious.  They’ll face increasing problems with physical and mental activity. The cognitive decline, physical health problems or a combination of the two. That create immediate safety risks or prevent them from completing their activities of daily living. Most assisted living or skilled nursing facilities at this point. 

4. Crisis Management  

It is the stage when the elderly needs immediate medical support. This may occur due to memory problems, Alzheimer’s or dementia etc. 

5. End of Life 

When the elderly people are nearing their final phase of life, they’re in the final stage of ageing. Some people may undergo all the five stages and some may shift from stage 1 to directly stage 5. That may be hard for the family members to accept this phase. 

Why do people age? 

While we don’t have a single definition for ageing. Let’s have a look on the theories that explain why do ageing occurs. 

1) Genetic Programming theories: These theories explain ageing as a genetically programmed one. 

• Programmed Senescence theory: Ageing happens as a result of the sequential on and off of certain genes. 
• Endocrine theory: the biological clock acts through genes that control hormonal changes. The Loss of muscle strength, accumulation of fat, decreased organ activity may be due to decline in hormonal activity. 
• Immunological theory: This theory imposes that certain gene causes problem in the immune system which make elderly people more prone to infectious disease. 

2) Variable rate theories or error theories: It explains ageing as a process influenced by internal and external environment that vary with every individual. 

• Wear and tear theory: It explains that ageing occurs due to the damage in the organ system at the molecular level. As ageing occurs the capacity in repairing of cell or organ reduces. It may happen due to internal and external stressors. 
• Free radical theory: During metabolism, unstable and highly reactive atoms are formed that lead to damage of the internal organ. 
• Rate of living theory: Faster the body works, more energy it uses and faster it wears out. 
• Auto immune theory: The tendency of the ageing body to mistakenly attack its own immune  systems leads to ageing. 

How do successful ageing works? 

Healthily adapting to the ageing process yield in successful ageing. Let’s see some theories  that works on this. 

i. Disengagement theory 

As part of normal ageing people tend withdraw connection from the society and become preoccupied with self. As part of ageing the disengagement becomes mutual.  

ii. Activity theory 

In contrast to disengagement theory, activity theory posits that in order to age successfully a person must remain as active as possible. 

iii. Continuity theory 

In order to age successfully one must maintain the balance of continuity and changes in both the internal and external structures in lives. 

All these theories explain how people adapt to ageing. 

Challenges faced by elderly people 

Biological factors 

• Physical health issues 
• Motor activities (reduced strength and speed) 
• Sensory Impairments 
• Weaken immune system 

Psychological factors 

• Irritability 
• Depression 

Social factors 

• Isolation 
• Neglect by others 
• Ageism 
• Reduced access and rights 

The biological and psychological factors occur due ageing and health issues but the social factors are those that were imposed by the society. This is the area we need to concentrate .

Psychological impact of social factors on elderly people 

Ageism 

Ageism is the prejudice or discrimination done to people on the basis of their age. It has a negative impact on the physical and mental health and also linked to lower life expectancy. 

Types of Ageism 

• Institutional Ageism: When an individual enforces ageist attitudes through their policies and actions. 
• Interpersonal Ageism: When an individual express ageist behaviors or attitudes during social interactions.
• Internalized Ageism: When a person adopts ageist beliefs and applies to their own sense of self.

How can we prevent ageism? 

• Break the myths and stereotypes over the elderly people. 
• Create awareness on the challenges and difficulties faced by the elderly people.
• Learn how ageism affects the older population. 
• Practice ‘elderspeak’ (a unique kind of speech pattern emphasizing on the slow and  careful speech and comforting talk). Elderspeak make the elderly feel that they’re  being listened and promotes dignity. 
• Sensitization program to counter ageism. 

Social isolation and loneliness 

As Older people have restricted mobility and functioning, they are more prone to loneliness and social isolation. It affects the quality of life, creates feeling of helplessness, anxiety and lowers self-esteem. 

How can we address social isolation and loneliness? 

• Understand the needs of the elderly people. 
• Talk with compassion, empathy. 
• Make them feel connected and cherish their wisdom. 
• Talk to them and make them realize they’re not alone. 
• Keep them engaged with some work. 

By understanding the process, challenges, struggles that individual faces as they age. We  deepen our responsibility to care for the elderly and uphold their dignity. 

Let’s learn something new  

When we talk about the health of elderly people, we should also focus on the burden of disease it can be measured using Disability Adjusted Life Years (DALY) 

Disability Adjusted Life Years (DALY) 

It is that sum of years lost due to health condition or disease. It combines both the Years  Lived with Disability (YLD) and Years of Life Lost (YLL)

Years Lived with Disability (YLD) 

It denotes the number of years an individual lives with disability due to specific health  condition. 

Years of Life Lost (YLL) 

This refers to the years of life lost due to premature mortality. 

Thus, addressing all these aspects ensures a more holistic approach to elderly health. 

While talking about the elderly population a story pops up in my mind which I’ve studied  during my school days, “The Porridge”. 

A little boy lived with his father, mother and grandfather. The grandfather used to have  porridge with a ceramic bowl, but one day his hand trembled and he dropped it. The  father and mother yelled at the grandfather and after that they started serving in the wooden bowl. The grandfather felt very embarrassed. The little boy who, observing the scene, quietly pondering over a piece a wood. When his father asked what he was doing, the boy replied, “Since you gave Grandpa a wooden bowl, I’m making one for you. I’ll give it to you when you’re old.”

We should understand that “How we treat others today is the mirror of how we will be treated tomorrow.” 

Let’s make sure that we treat the elderly with compassion and kindness. 

Being unwanted, unloved, uncared for, forgotten by everybody, I think that is a greater hunger, a much greater poverty than the person who has nothing to eat.

Mother Teresa