Introduction:Old age means reduced physical ability, declining mental ability, the gradual giving up of roleplaying in socio-economic activities, and a shift in economic status moving from economicindependence to economic dependence upon other‟s for support. Old age is called “dark” notbecause the light fails to shine but because people refuse to see it (Gowri 2003).Old age can be called as the near end of the life cycle of any human being. This is the time of(human) life at which corrosion and fall of physical abilities including sight, hearing, walking(stick required), etc. get started. This age is considered as the dependent age and also noneconomic age due to deterioration of physical abilities. This is the time at which a person givesup work as age does not allow him to do as much work as he was able to do in his young life. Ingeneral, the age of 65 years and above is considered old age in present times. This age is about60 years in Pakistan. The proportion of old people in the total population in the developed worldand even more rapidly in many developing countries is rising due to improvement in healthfacilities. The basic requirements of old people today are their better care in terms of their social,health and financial security. It is realized all over the world to do care of old people and toprovide them with their basic needs and independence (either economically or any other) as theirbasic right. This problem is also being attended by world‟s international organizations as well.(Azam, H., et al. 2012)There are different ways to provide them with some basic needs. There are pension schemes tomake them economically independent whereas a pension is a steady income given to a personusually after retirement. There are old homes to provide them with some sort of shelter, food andbasic facilities of life. Family is the main source of care giving to all its members. One‟s need forand ability to give care is negotiated by one‟s place in family life cycle. Ageing of population isan obvious consequence of the process of demographic transition. In a globalizing world, themeaning of old age is changing across cultures and with in countries and families (Bergeron2001). According to Mayor (2006), “Some people use their chronological age as a criterion fortheir own aging whereas others use such physical symptoms as failing eye-sight or hearing,tendency to increase fatigue, decline in sexual potency etc.The traditional sense of duty and obligation of the younger generation towards their oldergeneration is being eroded. The older generation is caught between the decline in traditional
values on one hand and the absence of adequate social security system on the other (Gormal2003).Elderly Population in Pakistan:Currently special rehabilitation facilities do not exist for old persons in Pakistan. Traditionallyadult sons and daughters are obliged to take care of their old parents and virtually all cared for inthe traditional way. Children are expected to look after their parents those who do not areregarded with disfavor by society. Although extended family system is no more a ruleparticularly in the urban areas, at least one of the offspring usually looks after the parents.Neglect of the elderly is rare. Old people‟s homes are non-existent, almost all live with membersof their family and generally satisfied with their lives. Religious faith is their main source ofstrength and their routine activities consist of prayers and other religious obligations.Nevertheless, the increasing numbers of the elderly pose a challenge including those relating totheir health and consequent disability principally on account of aging problems, senile dementia,deafness, blindness, and feeling of loneliness, uselessness and boredom. As times passes by thedemand for specific geriatric care would grow. Much remains to be done in the training of moreand better rehabilitation medicine care providers. There is a need for services that can beintegrated into the PHC system and cover a wide range of elderly peoples‟ health problems.Curative, preventive and rehabilitative care for the disabled elderly should be part of PHCprogram.With the overall strains on familial networks in the face of poverty, the vulnerability of manyelderly people in Pakistan increased in recent years, particularly when their children arethemselves too poor and over-burdened to care for them. Elderly Population (million) (60+ years) Year Total Male Female Census 1951 1.92 1.03 0.89 1961 2.92 1.68 1.24
1972 4.57 2.63 1.94 1981 5.88 3.40 2.48 1998 7.34 3.99 3.35 Projected Estimates 2013 11.19 5.69 5.50 2030 22.07 11.09 11.09 Table 1: The Elderly Population in Pakistan (past, current & projected) AGE (YEARS) ALL AREAS URBAN AREAS RURAL AREAS (Total Population) (Total Population) (Total Population) ALL AGES 133652121 47739853 85912268 60-64 2671393 910139 1761255 65-69 1852989 638216 1214773 70 & OVER 2611352 852984 1758368 Table 2: Population by Age, Sex and Urban-Rural Residence PDS 2001 Pakistan 60+ Population & Old Age Indicator Dependency Burden 60 + Population (in million) 8.1 (2000) 60 + Dependency Burden: 2000 (per one hundred 15- 59 pop.) 10.9 60 + Dependency Burden: 2050 (per one hundred 15- 59 pop.) 19.8 Table 3: Selected Socio-Economic and Health Indicators of PakistanVulnerable elderly are primarily affected when having lost family support or having sufferedinjuries and disability. Where the elderly provide for the protection of other dependants, theyoften face a double protection dilemma. Older people are often marginalized and frequently failto access humanitarian aid and basic services for reasons of poor mobility, social „invisibility‟
and the erroneous assumption that „someone‟ is taking care of them already. The challenge willbe to ensure that the elderly will not be overlooked in the reconstruction and rehabilitationprograms.The Elderly face specific problems in relation to health and medical treatment. They faceproblems accessing health facilities due to mobility issues and therefore specific interventionsrequire health service providers going to them. Chronic health conditions and medical problemspertaining to the elderly include nutritional deficiencies, chronic diabetes, eye problems anddental problems. A series of mobile eye camps, dental camps and mobile medical camps will beencouraged so as to address the specific health problems of the elderly, and also cater to othersrequiring such treatment.The elderly with no adult caretakers (or even with adult caretakers, but who are still neglected)require support in the reconstruction of their houses in cases where they owned the property.There may be a substantial number of elderly who do not have their own houses due to propertyand/or compensation being taken over by family members, often their own children. In caseswhere elderly have no land, shelter or adult support, culturally-sensitive arrangements such asthe Dar-ul- Kifala, can be made available, in which living arrangements for the elderly and thedestitute are provided by the Government. This model is already in operation in NWFP.Despite intensive extraordinary socio-economic pressures, Pakistani society has stood for highvalue, respect and dignity of human life. We in Pakistan, regard old age as a mark of esteem,wisdom and piety. This could be attributed to the strong ties that exist in the joint family systemnurtured by religious values, dignifying the status of elderly segment of society.The last century has witnessed a rapid increase in the population of the elderly people in thedeveloped and industrialized countries. This phenomenon is not restricted to the western worldonly, but many countries such as ours are now feeling the impact of this transaction. Thissituation could be attributed to a combination of factors such as increase in age, longevity anddecreased death rates due to advancement in the field of medicine, improvement of lifeexpectancy at birth, and enhancement in the average span of life ( Dubey, A and et al. 2011).
Zephyr valley Old HomeIntroduction:The Zephyr valley Home for the Elders, a non-profit organization and charity, is on the leadingedge of being one of the best nursing homes with best practice. It is viewed as a state-of-the-artnursing home offering an outstanding spectrum of health care services to meet the needs of theelderly. We are one of the first nursing homes to be accredited by the Ministry of Health as anApproved Service Provider, providing Step-Down Care that includes accommodation, personal& health care for elderly suffering or recovering from any sickness, disability or injury.Name:This society shall be known as the “Zephyr valley Home for the Elders” hereinafter called the“Zephyr valley Home”.Place of Business:The place of business of the Zephyr valley Home shall be in Gujrat distt. Or such other addressas may subsequently be decided by the Management Board and approved by the Registrar ofSocieties. The Zephyr valley Home shall carry out its activities only in places and premiseswhich have the prior written approval from the relevant authorities, where necessary.Reason of selecting Gurjat:Reason in Gujrat city because of family disputes they left their elders at home, high ratio ofpeople migrate to other cities and on the back only elderly remain here and face lack of familysupport.Scope of organization:This organization is working on regional level.Objectives 1. To provide shelter and care to Gujrat citizens and Permanent Residents who are aged destitute and those in need of nursing or respite care, ambulant, non-ambulant sick, or otherwise, regardless of their race, sex or religion.
2. To attain the above objectives and provided that nothing is done for commercial reasons, the Zephyr valley Home shall: a. Acquire, build or, maintain a Home to accommodate b. Provide day care to the aged sick, and/or those in need of nursing or respite care, ambulant and non-ambulant sick, or otherwise, regardless of their race, sex or religion c. Undertake any activities as are incidental to the attainment of the above object; d. Become affiliated to any organization which would further the cause of the Zephyr valley Home; e. Raise funds for the above purposes.Areas of activity:Following are the area of activities Ageing Shelter for elderly Health care Social work and advocacy Awareness campaign Mission and Purpose: The mission of the Zephyr valley Home is to provide full range of services to the elders of Gujrat district with a purpose to maintain & promote the physical, mental and social well being of elders by enhancing their quality of life and to assist them in remaining independent and active.Aims & objectives:Following are the aims & objectives of Zephyr valley Home.
1. To create love & understanding amongst all the seniors. 2. To facilitate the members for Medical treatment 3. To help & assist the members in the solution of their problems. 4. To arrange outings of members, at recreational places & Gardens. 5. To assess the health, activity and social status of the elderly. 6. To make them busy so that they do not feel loneliness.Our Services 1. 24-hour Nursing and Medical Care Zephyr valley Home for the Elders is fully dedicated to meeting the needs of each resident. Zephyr valley Home addresses the medical and psychological needs of every resident with a spirit of excellence. At the Zephyr valley Home, caring for the body, mind and spirit of each individual is given top priority with round-the-clock nursing care by professionally trained nurses, assistant nurses, nursing aides and healthcare attendants. Together, they helped to improve the clinical outcomes for the residents particularly in areas such as infection control, prevention of pressure sores and end-of-life care. Their expertise and organizational skills in determining cost and quality of care also provided the Home with a competitive advantage in the healthcare marketplace. A general practitioner visits the Home 3 times a week, together with regular visits from geriatricians, psycho geriatricians and other medical specialists who conduct assessments and consultations. With a team that is equipped and ready to cover all aspects of medical care, residents are guaranteed to receive the highest level of support 24-hours a day, 7 days a week. 2. Short-term and Long-term Rehabilitation With full-time physiotherapists and occupational therapists on-site, as well as a clinically equipped gymnasium, the Zephyr valley Home offers short-term and long-term rehabilitation to residents. o Short-term rehabilitation programs help residents recovering from stroke or fracture resume an independent lifestyle in the community. This program is
designed to focus on the restoration of functionality through a combination of physical, occupational and speech therapy. o For residents with a functional impairment, chronic ailment or dementia, long- term rehabilitation is often recommended to help prevent further deterioration of their condition as well as to improve their level of comfort. Treatment can involve a combination of person-centered care by our team of nursing staff, coupled with physiotherapy, occupational therapy, speech therapy, dietitian and pharmacist. 3. Physiotherapy and Occupational Therapy A key focus at the Zephyr valley Home is the physical and mental wellbeing of each individual resident. The Home‟s full-time rehabilitation therapy staffs are dedicated to strengthening residents‟ physical bodies as well as re-establishing their sense of independence. Physiotherapists and occupational therapists work hand-in-hand with the Zephyr valley Home‟s medical team and other clinical expertise to design customized therapeutic programs that help restore residents‟ functionality and develop confidence.While programs may differ from resident to resident depending on their needs and abilities, their goals remain the same: o Increase, restore or maintain range of motion, physical strength, flexibility, coordination, balance and endurance o Promote independence with the improvement of walking skills o Increase overall fitness through exercise programs o Improve sensation, reduce pain and discomfortWe have achieved much success from recognizing that physical therapy is a “hands-on” process.Our specialists work with residents on a one-on-one basis because this helps to bring out the best in each resident‟s capabilities
4. Resident Social Life The Zephyr valley Home organizes arts & crafts activities, cooking, concerts and monthly outings to local hawker centers, markets and shopping malls for residents to learn, grow, express themselves and just have fun. These social activities help to stimulate the intellect, rebuild strength and raise the spirits of our residents5. Social Work and Advocacy The Home has social and welfare workers on-hand to help residents adjust to communal living. Offering counsel, guidance and support, our social and welfare workers maintain ongoing relationships with both residents and their families to ensure that their concerns are being met and their problems addressed. With an interdisciplinary team that includes social work, the Home makes sure that residents‟ rights and needs are attended to at all levels. Staff at the Zephyr valley Home takes resident advocacy very seriously. The level of care that a resident requires is always taken into consideration first before our staff work as a team to custom-design treatment programmes for each resident.6. Management and Care of Dementia Contrary to common belief, people suffering from dementia are able to live at home. Those admitted to the Zephyr valley Home generally have more diverse and complex needs in addition to dementia. Given the dynamic environment at the Zephyr valley Home (with the differing and changing needs of residents), our highly skilled staff are more than capable of coping under high-stress situations with great understanding, insight, compassion and the commitment to treat each and every resident as a valued individual. o Pets Corner... It‟s a proven fact that pets offer constant interest, stimulus and help satisfy the need for contact. Our Pets Corner offers pet therapy by creating a homelike environment and provides enjoyment to both residents and their visitors. o Yesteryear Room... Our Yesteryear Room provides reminiscence therapy for residents. This form
of therapy acts is known to be effective in enhancing self-esteem, reducing isolation and providing comfort and familiarity for the elderly. Especially for residents with dementia, reminiscence therapy helps stimulate communication and interaction with others by encouraging them to recollect things and events from the past7. Scheduled Respite Care In addition to the long-term care offered by the Zephyr valley Home, scheduled respite care is available on a short-term basis. This service offers nursing care and lodging, and is ideal for families looking for a temporary arrangement for their loved ones in need of medical and nursing care.8. Training & Education Zephyr valley Home believes in providing quality holistic care to our residents. To achieve this requires growing the number of competent and knowledgeable nurses and care assistants in the Home. We therefore place a great emphasis on continuing education, on-the-job training, and clinical based research. To provide holistic care requires a multidisciplinary and interdisciplinary approach, integrating inputs from program to management to staff activities. Hence Zephyr valley Home provides in-service training in multiple disciplines, and also constantly reviews corporate-wide processes including management structures, staff activities and resident outcomes to ensure high quality and standard of care and services. All of these efforts are aligned with our efforts to improve our knowledge-based and evidence-based practices in long-term care.9. Elderly rehabilitative day activities Elderly rehabilitative day activities support living at home and coping at home despite illness and paramnesia. Day activities offer also social intercommunication and stimulating participation. These activities include breakfast, lunch, coffee and transportation at need. You can join day activities through your local social and contact work units of elderly services.
10. Senior Day Care Centers Senior Day Care Centers provide facility-based programs for frail elderly who are able to reside at home and travel to other locales if supervision is available. Services are designed to meet the clients needs by personnel trained to work with physically- dependent seniors. Some centers accept persons with dementia.11. Old is Gold Studio A very important objective of our Zephyr home is the awareness campaign using electronic media , radio and television in order to set standards regarding aging population and their problems and issues and techniques to get rid of those issues. The most important part is that the elders admitted in Zephyr home are itself promoted and polished to perform and act in different departments of the studio, in this way not only we can provide them with savings of their own but also this activity keeps them busy all the time and they don‟t have time to think about their nightmares.
References: 1. Session Session-I “Addressing Coverage Gaps in Pension Schemes in Pakistan”. Panelist Sabur Ghayur Chairman, Policy Planning Cell Labour and Manpower Division Islamabad. EOBI/WBI Key Challenges in Pension Policy in Pakistan Pension Pakistan””99--10 May 2007, Islamabad10 Islamabad. Retrieved from http://info.worldbank.org/etools/docs/library/241484/Session%252001May9Sabur%252 0Ghayur.pdf 2. Pakistan demographic survey – 2001. Federal Bureau of Statistics. Retrieved from http://www.statpak.gov.pk/depts/fbs/statistics/pds2001/pds2001.html 3. Source: Different sources were used including the World Bank (2000, 2001); Human Development Centre (1997, 2002); ADB (2001); Planning Commission of India (2002); UN‟s Population Prospects (2002 Revision). 4. Azam, H., Ahmad N and Ahmad B. 2012. Determinants of Work Responsibilities of Pensioners in Pakistan: A Case Study of District Khushab. International Journal of Business and Behavioral Sciences: 2(8). 5. Gormal K 2003. Aged in India. Mumbai: Tiss Publishers. 6. Mayor R 2006. Significance of grandparents: Perceptions of young adult grandchildren. Gerontologist, 16(1):137-140. 7. Bergeron LR 2001. An elderly abuse case study: Case gives stress or domestic violence. Journal of Gerontogical Social Work, 34(3): 47-63. 8. Gowri GB 2003. Attitudes towards old age and ageing as shown by humor. Gerontologist, 17(2): 220-226. 9. Dubey, A., Bhasin S., Gupta N., and Sharma N. 2011. A Study of Elderly Living in Old Age Home and Within Family Set-up in Jammu. Stud Home Com Sci, 5(2): 93-98