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- 2. Outline of presentation • Introduction • Concept of aging • Definition of successful aging • Factors contribute to healthy ageing • Common problems at old age • Role of Social worker • Conclusions
- 3. Introduction • Advances in public health and in health care are keeping people alive longer, and consequently, the proportion of older people in the global population is increasing rapidly. • The life expectancy has also increased in India. Compared to life expectancy of 32 years at the time of independence, it was estimated to be 65 years for the year 2011. • Those aged >60 years formed 5.5% of the total population in 1951, which increased to 8.5% in 2011 and it is projected that by 2050, elderly will form 19% of the total population, with higher growth for those aged ≥80 years. Census of India, 2011.
- 4. Introduction • Between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22%. • By 2020, the number of people aged 60 years and older will out number children younger than 5 years. • In 2050, 80% of older people will be living in low- and middle-income countries WHO 2018
- 5. Classification of old age (Government of India. 1999). Old Old-old Oldest old 60-69 70-79 80+
- 6. Classification • According to WHO most countries have accepted the chronological age of 65 and above as a definition of elderly and old age • According to the UN 60+ years will be referred as the older population or elderly • Young adult – up to 75years • Old Old- up to 85years • Very old -85 years
- 7. Health characteristics in older age • Underlying changes • Movement functions • Sensory functions • Cognitive functions • Sexuality • Immune function • Functions of the skin • Multimorbidity
- 8. Health condition during aging • Hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression and dementia. • Also characterized by the emergence of several complex health states that tend to occur only later in life and that do not fall into discrete disease categories. These are commonly called geriatric syndromes. • Often the consequence of multiple underlying factors and include frailty, urinary incontinence, falls, delirium and pressure ulcers. • Geriatric syndromes appear to be better predictors of death than the presence or number of specific diseases. WHO 2018
- 9. Concept of aging • As a multidimensional reality of life, aging is difficult to define simply • Ageing results from the impact of the accumulation of a wide variety of molecular and cellular damage over time. • Beyond biological changes, ageing is also associated with other life transitions.
- 10. Definition of aging • The National Institute on Aging states that “in its broadest sense, aging merely refers to changes that occur during the lifespan.” • The World Health Organization (WHO) defines aging as a “process of progressive change in the biological, psychological and social structure of individuals.”
- 11. Social Theories of Aging • Disengagement Theory . • Activity Theory • Continuity Theory
- 12. Successful aging • Successful Aging is a prominent theme in gerontology. • The phrase was introduced by Robert Havighurst in 1961 at a time when Cumming & Henry’s ‘‘Disengagement Theory’’ 1961 ) was popular
- 13. Successful aging: conti.. • Concept was also referred differently. • Various synonymous terms used include positive aging, active aging, aging well, healthy aging, optimum aging, productive aging, vital aging, and robust aging. • In recent decades, the most popular term in the united states has been successful aging. • In Europe has been active aging.
- 14. WHO Definition of successful ageing WHO defines Healthy Ageing “as the process of developing and maintaining the functional ability that enables wellbeing in older age”.
- 15. Definition of successful aging According to Rowe And Kahn Successful aging to include three main components. Having low probability of disease and associated disability, High cognitive and physical functioning, Active engagement with life Further emphasized that successful aging does not merely involve the absence of disease or maintenance of functional capabilities, but requires combination of both along with active engagement with life.
- 16. Obstacles for successful ageing • Poverty • Social inferiority • Social isolation • Physical weakness • Powerlessness and humiliation Grover, S. (2016).
- 17. Factors contribute for successful aging
- 18. Physical factors • A person’s physical health before the age of 50 • Absence of cigarette and alcohol abuse • A healthy body mass index (between 21 and 29) at the age of 50 • Moderate exercise • Fewer chronic medical conditions
- 19. Psychological factor • Psychological factors as predictive of successful aging Lower rates of depression and higher rates of resilience are more likely to age well. • Feeling that one has a purpose in life . • People that have mature (adaptive) defences.
- 20. Social Factors • A happy marriage a greater social support and more social contacts • Higher education
- 21. Strategy to lead successful ageing
- 22. Physical activity • contributes to reducing the risk of several diseases associated with aging including cardiovascular disease, metabolic disease and osteoarthritis • American College of Sports Medicine guidelines, at least 150 minutes of moderate weekly physical activity (30 minutes, 5 days/week) is recommended to obtain health benefits 10 Harmell, A. L .et.all(2014).
- 23. • several epidemiological studies demonstrating a relationship between higher levels of physical activity and lower levels of cognitive decline and/or enhanced cognitive functioning in domains such as verbal memory, executive functioning, attention, and global cognition. • One study of 1324 subjects reported that moderate (as opposed to light or vigorous) exercise in mid-life and late-life was associated with a reduced risk of mild cognitive impairment. Geda, Y. E et.all(2010).
- 24. Cognitive Stimulation/Remediation • Encouraged to independently engage in daily cognitive stimulating activities. • Reading, Practicing crossword puzzles Playing board/card game • There is some evidence to suggest that frequent engagement in cognitively stimulating activities for at least six hours per week may reduce the risk of incident dementia. Hughes TF . Et. All 2010
- 25. Diet/Nutrition • Caloric restriction • High consumption of fruit and vegetables • High ratio of polyunsaturated to saturated fats
- 26. Complementary and Alternative Medicine • Yoga and meditation are potentially impactful interventions • Benefit is in improving sleep.
- 27. Social Engagement • Social engagement can be defined as making social and emotional connections with other people such as family/friends and the community (e.g., being an active participant in clubs, religious organizations, volunteer work). • The association between social engagement and health and well-being has been well- documented throughout the lifespan. • In many ways, increased age can be considered a risk factor for social withdrawal, as a result of physical decline and retirement. • A recent meta- analysis found that social engagement was as strong a protective factor for health as many other established risk factors.
- 28. Strategy to lead successful ageing • Cognitive stimulation ‐ mental activity • Healthy diet, eat right quantity • Self‐management programs • Avoid smoking • Moderate alcohol use • Good oral hygiene • Health screening • Minimizing stress • Social involvement • Immunizations
- 29. Strategy to lead successful ageing • Clean environment • Home safety • Attitude of lifelong learning • Active involvement a hopeful outlook • Maintain a positive outlook on life • Take good care of your health • Remain active • Stay in close contact with family and friends • Remain mentally active ‐ learn new skills • Meditation • Yoga Sandeep Grover.2017
- 30. Role of social work • Social assessments • Advocating • Network and liaise • Empower themselves • Counseling • Work with families and carers • Risk assessment and risk management
- 31. Conclusion • It is important to take a holistic view of what contributes to aging successfully. • Those that are most likely to age well have good physical and psychological health as well as a social support network. • Successful aging is not only the absence of chronic illness, but the perceived life satisfaction of the elderly person.
- 32. References • Robson, S. M., Hansson, R. O., Abalos, A., & Booth, M. (2006). Successful aging: Criteria for aging well in the workplace. Journal of Career Development, 33(2), 156-177. • Gingold, R., & Gingold, R. (1992). Successful ageing. Melbourne: Oxford University Press. • Raju, S. S. (2014). Studies on ageing in India: A review. Population Ageing in India, 180. • Galligan, D. (2002). Psychosocial Factors that Promote Successful Aging. Journal of Aging and Health, 12(4), 470-89. • Carver, L., Beamish, R., & Phillips, S. (2018). Successful Aging: Illness and Social Connections. Geriatrics, 3(1), 3. • Weichold, K., & Sharma, D. (2014). ISSBDBulletin. 2016 BULLETIN Number 1 Serial No. 69 • The Role of the Social Worker with Older Persons Prepared by: The Irish Association of Social Workers’ (IASW) Special Interest Group on Ageing (SIGA) Revision: August 2011 • Harmell, A. L., Jeste, D., & Depp, C. (2014). Strategies for successful aging: a research update. Current psychiatry reports, 16(10), 476.
- 34. Thank you
Editor's Notes
- Common conditions in older age include hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia. Furthermore, as people age, they are more likely to experience several conditions at the same time. Older age is also characterized by the emergence of several complex health states that tend to occur only later in life and that do not fall into discrete disease categories. These are commonly called geriatric syndromes. They are often the consequence of multiple underlying factors and include frailty, urinary incontinence, falls, delirium and pressure ulcers. Geriatric syndromes appear to be better predictors of death than the presence or number of specific diseases. Yet outside of countries that have developed geriatric medicine as a specialty, they are often overlooked in traditionally structured health services and in epidemiological research.
- ageing results from the impact of the accumulation of a wide variety of molecular and cellular damage over time. This leads to a gradual decrease in physical and mental capacity, a growing risk of disease, and ultimately, death. But these changes are neither linear nor consistent, and they are only loosely associated with a person’s age in years. While some 70 year-olds enjoy extremely good health and functioning, other 70 year-olds are frail and require significant help from others. Beyond biological changes, ageing is also associated with other life transitions such as retirement, relocation to more appropriate housing, and the death of friends and partners. In developing a public-health response to ageing, it is important not just to consider approaches that ameliorate the losses associated with older age, but also those that may reinforce recovery, adaptation and psychosocial growth.
- The difficulty in precisely defining aging and its determinants leads to an imprecise definition of successful aging. The stage was set for its emergence, however, by changes in the social theories of aging. The transformation in social thinking shifted the view of aging from a fatalistic to an optimistic outlook for the latter decades of life. Three major social theories of aging—disengagement theory, activity theory, and continuity theory— best demonstrate this shift in thinking. Disengagement theory is the earliest formal social theory of aging proposed by Cumming and Henry in 1961.16 The major assumption of this theory is that older people gradually withdraw from social activities and social roles to prepare for their ultimate demise. According to this theory, disengagement is a natural and inevitable consequence of aging, and older people who willingly accept their fate experience greater contentment and well-being.16 Although viewed as ageist in contemporary literature17-20 and no longer accepted by many gerontologists,21-23 the disengagement theory of aging holds its value in the theoretical controversy it inspired.24-26 In 1963, Havighurst27 formalized the activity theory of aging in direct opposition to the disengagement theory. The activity theory suggests that people experience greater satisfaction with life by maintaining social activities and social roles as opposed to living solitary lifestyles. In addition, as roles are lost by age-associated changes, new roles or activities should be substituted for a continued sense of fulfillment.27-29 In 1989, Atchley30 presented a more formal elaboration of this theory, known as the continuity theory of normal aging, which has gained considerable support.22,31-34 According to the continuity theory, older individuals typically maintain the same behaviors, preferences, and relationships as in earlier life. In addition, life satisfaction depends on how consistent people’s current behaviors are with those exhibited throughout the life span as well as their ability to adjust and adapt to the challenges of aging by substituting and redistributing activities.30 The assumptions of the continuity theory of normal aging have been substantiated through the results of longitudinal research studies.31,35-38 Both the activity and continuity theories suggest that any declines in social interaction among aging adults might be attributed to decreased health and physical function as opposed to an intrinsic need to withdraw from society as the disengagement theory indicates.27-30 The former theories signaled a paradigm shift in gerontology research away from a deterministic negative view of aging toward a search for an understanding of why some age well but others do not.
- Functional ability is about having the capabilities that enable all people to be and do what they have reason to value. This includes a person’s ability to meet their basic needs; to learn, grow and make decisions; to be mobile; to build and maintain relationships; and to contribute to society Functional ability is made up of the intrinsic capacity of the individual, relevant environmental characteristics and the interaction between them. Intrinsic capacity comprises all the mental and physical capacities that a person can draw on and includes their ability to walk, think, see, hear and remember. The level of intrinsic capacity is influenced by a number of factors such as the presence of diseases, injuries and age-related changes. Environments include the home, community and broader society, and all the factors within them such as the built environment, people and their relationships, attitudes and values, health and social policies, the systems that support them and the services that they implement. Being able to live in environments that support and maintain your intrinsic capacity and functional ability is key to Healthy Ageing.
- Low probability of disease refers not only to absence or presence of disease itself, but also to absence, presence, or severity of risk factors for disease. High functional level includes both physical and cognitive components. Physical and cognitive capacities are potentials for activity; they tell us what a person can do, not what he or she does do. Successful aging goes beyond potential; it involves activity. While active engagement with life takes many forms, we are most concerned with two — interpersonal relations and productive activity. Interpersonal relations involve contacts and transactions with others, exchange of information emotional support, and direct assistance. An activity is productive if it creates societal value, whether or not it is reimbursed. Thus, a person who cares for a disabled family member or works as a volunteer in a local church or hospital is being productive, although unpai
- The rate of increasing of the elderly population is increasing and India’s aged population is second largest in the world People below the poverty line lack efficient social security Thus, the safety of elderly is built socially weak. broken family network due to unemployment and urban f the younger generation affects the lives of elderly all of them belonged to below the poverty line. Occupationally, they were mainly agriculture labour, daily wages labour and rural artisans. The result showed that they had no any relaxation in their rest life and they had to manage their own needs. They lived with hunger and their health care and other needs were unfulfilled The social as well as the family support and assistances was very thin or virtually absent. There was also absent of government social security i.e. old age pension and rationing facilities. But, they were the voters and only during the election period, they used to receive honour with some facilities i.e. food grains, cloth and others. Sometime, they used to get enough assurance for an old age pension. But practically, it was vanished after election days. Thus, their poor economy was the main burden for their successful aging. Changing family dynamics and relations had been failed to assure care of the elderly by their offsprings. So, successful aging is a dream to bring happiness of the poor elderly population in their rest of the life. It is a huge lack for strengthening the slogan - ‘respect senior, secure their survival and ensure happy deat