A study on depression of senior citizens in the institutions at Wayanad District.

LITERATURE REVIEW

Introduction

The elderly population is large in general and growing due to advancement of health care

education. These people are faced with numerous physical, psychological and social role changes

that challenge their sense of self and capacity to live happily. Many people experience loneliness

and depression in old age, either as a result of living alone or due to lack of close family ties and

reduced connections with their culture of origin, which results in an inability to actively

participate in any activities. Aging is a series of processes that begin with life and continue

throughout the life cycle. It represents the closing period in the lifespan, a time when the

individual looks back on life, lives on past accomplishments and begins to finish off his life

course. Adjusting to the changes that accompany old age requires that an individual is flexible

and develops new coping skills to adapt to the changes that are common to this time in their

lives. It is considered, that it is the duty of the children to take care of their parents in their old

age. However today we are witnessing a massive increase in the number of old age homes, or

the more fashionable, retirement homes. Aged people are becoming more and more isolated and

youngsters have less and less patience in handling them or adjusting with them. Many high

earners and men and women with class and status in society can’t stand the sight of their aged

and ailing parents and leave them to the institutions not even looking back again.

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Senior citizen:

According to study, individuals belonging to the age group of 60 and more than 60 years are

considered as senior citizens in the society. Old age is a difficult time for many people, a time of

declining health, reduced income, the loss of a meaningful role, or the death of loved ones. These

problems can create great unhappiness for elder people and can damage relationships with

spouses and children. In extreme cases, this damage can lead to mental illness or depression.

World Population is facing rapid changes in age structure. Because of epidemiological and

demographic transition, the mortality rates have been declined in the world. At the same time,

because of availability of family planning services and other social conditions fertility rates are

also declining. As a result, people are surviving more and it is producing elderly people

gradually. The world population 60 plus is increasing rapidly. Thus, in Indian population, senior

citizens also form a noticeable percentage of total population. According to the 1947 census, the

population of senior citizens in India was 350 million and it was increased to 1.15 billion in

2010. The geriatric population of India accounts more than six per cent of the total population.

The number of elderly in Kerala is expected to reach 7.2 million by 2021 and 11.9 millions in

2051.

Aging is a universal process. Seneca says that "old age is an incurable disease". Sir

James Sterling Ross commented on aging as "you do not heal old age, you protect it, you

promote it and you extend it”. For any country the senior citizens are a precious asset. They

contribute their might for sustenance and progress of the nation with their rich experiences and

wisdom. Since the expectation of life is also increasing steadily and quality of life is being

emphasized more in our country. The senior citizens are getting importance day by day. World

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Health Organization is also concerned about the health of this group and is promoting the

concept of healthy aging. The elderly population is large in general and growing due to

advancement of health care facilities. These people are faced with numerous physical,

psychological and social role changes that challenge their sense of self and capacity to live

happily. Many people experience depression in old age, either as a result of living alone or due to

lack of close family ties and reduced connections with their culture of origin, which results in an

inability to actively participate in the community activities.

Depression is a common affective illness found in old age. It is a mood disturbance

characterized by exaggerated feelings to sadness despair, lowered self esteem, loss of interest in

former activities and pessimistic thoughts. The incidence of increased depression among the

elderly is influenced by the variables of physical illness, functional disability and cognitive

impairment.

Types of health problems among senior citizens

India has acquired the label of an ageing nation. The elderly suffer from mainly two types

of health problems that are given below:-

1. Medical:- Common medical problems are;

a. Cardiovascular

b. Visual

c. Musculoskeletal

d. Gastrointestinal diseases

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2. Psychosocial:- Common psychosocial problems are;

a. Depression

b. Impaired memory and intelligence

c. Anxiety

d. Rigidity of outlook

e. Dependency and dissatisfaction with family members.

Senior citizen’s Depression

Aging is associated with an increase in need for assistance and are very usual people

regarding the fear of dying and declining capacities with stress and anxiety. Older people are at

higher risk of increasing health problems as well as social isolation through loss of spouse, close

family members and friends. In addition, residential relocation is common, moving from a family

home to an institution, which implies a change in informal relations. All these factors are

associated with an increased risk of experiencing depression. Definition of depression is ‘a

mental condition characterized by feelings of severe despondency and dejection, typically

associated with feelings of inadequacy and guilt, often accompanied by lack of energy and

disturbance of appetite and sleep’. (Stevenson) Depression, particularly mild depression, is

common in among older people, especially among male. The healthcare professional should take

proper interventions to overcome the depression in geriatric population. The family members

should take care of their elderly people and should spend time with them to make them feel

comfortable. Also the government should take initiative to set up geriatric club where they can

spend time along with other friends of the community and share their thoughts. In Indian society

the increasing number of older people has been well perceived. Though increase in ageing

population represents the success of socioeconomic development and good public health

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practice, it has also lead to economic and social crisis due to increased demand for health and

welfare services.

Depression is a psychiatric disorder in the elderly that leads to a decrease in quality of life

and functional impairment, among other health problems. Depression is defined as a psychiatric

disorder, common in elderly individuals, and considered as a public health problem due to its

association with several chronic diseases, cognitive dysfunction, and functional impairment .This

disturbance causes suffering to the patient and the family, presenting a natural course of

profound sadness along with lack of stimulus for daily activities, and lack of interest or pleasure

in carrying out simple and routine tasks. Leaving the family home to live in a nursing home is

strongly associated with depressive symptoms, in addition to the feeling of loss of autonomy,

change of environment, and difficulties in adapting to the institution, restricted social life, and

low level of physical activity, among others. Studies by Archana Singh and Nishi Mishra has

revealed that there are no significant gender differences in the elderly persons with respect to

loneliness and depression, i.e. both the male and female elderly persons equally experience

feeling of loneliness and depression.

Depression and Aging is the stage of the peoples when an older adult may also sense a

loss of control over his or her life due to failing eyesight, hearing loss and other physical

changes, as well as external pressures such as limited financial resources. These and other issues

often give rise to negative emotions such as sadness, anxiety, loneliness and lowered self-esteem,

which in turn lead to social withdrawal and apathy.

As a man ages, the indications of discouragement are a great deal more changed than at more

youthful ages. It can show up as expanded tiredness or it can be seen as grumpiness. In some

cases individuals who are discouraged lose enthusiasm for eating and can get more fit.

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Signs and symptoms of depression:

Depression is a mental health condition. It is a mood disorder in which feelings of

sadness, loss, anger, or frustration interfere with daily life for weeks or longer. Depression in

older adults is a widespread problem, but it is not a normal part of aging. Depression is one of

the most common psychiatric disorders worldwide. The World Health Organization ranked it as

the leading cause of morbidity, resulting in high utilization of health services and decreased work

productivity. Depression reflects a range of biological and social factors and it may be difficult to

diagnose in elder people as its presentation may differ from that of younger people. Elder people

tend to under-report depressive symptoms and may not acknowledge being sad, down or

depressed. This could be due to age, shame and lack of understanding for the disorder or a belief

in not talking about depression or admitting to not coping. Often, common depressive symptoms

(such as a loss of interest in life, lack of enjoyment in normal activities, apprehension, poor

sleep, persistent thoughts of death, chronic unexplained pain, poor concentration or impaired

memory) are incorrectly attributed to old age, dementia or poor health. Too frequently, family,

friends and doctors interpret these symptoms in that way as well; with the result that depression

in old age may go undetected and untreated for a long time. The symptoms are given below;

Sadness

Feelings of worthlessness

Irritability

Fatigue

Crying spells

Apathy

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Restlessness

Lack of concentration

Withdrawal

Sleep problems

Changes in appetite

Thoughts of suicide

Physical aches and pains

Types of depression in older people

The most common type of depression in older age is non-melancholic depression which is linked

to psychological factors, personality characteristics and stressful life events. However, when

there is a history of depression in earlier life, it is likely that genetic factors may contribute to the

course of the depressive illness. Depression that first develops in later life, usually after age 60,

is more commonly associated with physical health problems that accompany ageing. An older

person in good physical health with no history of previous episodes has a relatively low risk of

developing depression at a later age.

Causes of senior citizens depression

Depression doesn’t have one single cause. Brain chemistry, hormones, genetics, personal

risk factors may all play a role. Some research indicates that there could be a genetic link to the

disease. However, biological, social, and psychological factors all play a role in depression in the

elderly in the institution. Many people experience depression in old age, either as a result of

living alone or due to lack of close family ties and reduced connections with their culture of

origin, which results in an inability to actively participate in the community activities. Social

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and cultural shift has also encroached the rural India which for centuries has boasted of a joint

family system with high respect for its elderly members. Depression in elderly lowers the

productivity and increases health care financial burden to the family members.

1. Physical ill health

There is a complex relationship between physical illness, disability and depression. Many

physical illnesses also cause depression through a variety of biological mechanisms. Physical

illnesses that can cause depression in old age include cancer, thyroid disease, vitamin

deficiencies and infections. There is also mounting evidence that cerebrovascular disease is an

important risk factor for late life depression. So it is essential that any older person who becomes

depressed for the first time in old age has a thorough medical evaluation. Many physical illnesses

in old age result in permanent disabilities which can restrict a person’s mobility and often require

assistance with self-care. This may result in loss of dignity, a sense of being a burden on others

and fears of institutionalization

2. Social isolation and loneliness

Many people experience social isolation and loneliness in old age, either as a result of living

alone, a lack of close family ties, reduced connections with their culture of origin, or an inability

(often through lack of transport) to actively participate in the local community. When this occurs

in combination with physical disablement, demoralization and depression are common.

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3. Painful events

Old age Symbolic and real losses are the psychological basis of many depressions.

Old age represents a period of life where losses are cumulative and frequent. Many elderly

people cope well with losses such as the death of their partner, siblings, friends and pets, and the

loss of independence, health, home and lifestyle. However, for other people, these losses can

trigger the development of depressive symptoms.

We can see some more reasons given below:

1. Low levels of key neurotransmitter chemicals in the brain (serotonin, nor epinephrine)

2. Family history of depression

3. Traumatic life events, such as abuse or the death of a loved one

4. Complications associated with aging may contribute to depression specifically in the

elderly.

5. Move away from own home to the institution

6. limited mobility

7. Isolation

8. Facing mortality

9. Deaths of friends and other members in the institution

10. Lack of contact from the family members

Ways to Cope With Senior Citizens Depression

When you have depression, you can find ways to take control of your life and manage your

treatment even beyond medications. Making some lifestyle changes can boost your mood and

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help alleviate many of your symptoms, including low self-esteem. Minimizing stress as much as

possible is a good idea when you're depressed, especially unnecessary or avoidable stressors that

people can be pulled into when they're depressed.

Talk to a Therapist

Working with a therapist is often an important part of successfully managing depression. Psychotherapy

will focus on helping people adjust their lifestyle in ways that are possible, Minimize their stress, and

cope with stressors. Among the issues that you can address together are how to improve your self-

esteem, switch from negative to positive thinking, and practice stress management.

Boost Self-Image

Senior citizens with depression often experience low self-esteem, so finding ways to feel better about

self is an important aspect of treatment. Practice positive thinking by focusing your thoughts on your

best qualities. You can also make lifestyle changes that can improve your self-esteem, such as eating a

healthy diet, getting regular exercise, and spending time with friends who make you feel good about

who you are.

Stick to a Schedule

Maintaining a healthy and regular routine is very helpful for senior citizens with depression.

Schedule an activity that you have to do every day make it one you really enjoy and aim for as

much balance as possible in their life.

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Stay Involved

If he/she is experiencing depression, he/she may feel to withdraw socially and keep toHim/herself,

either because of low self-esteem or a lack of interest. Social life is important, Push yourself to  stay

involved with your friends. Social connections can help keep you from spiraling downward into deeper

depression and from becoming isolated and alone with your thoughts.

Depend on Others

Friends and staff of the institution can help them feel better about him/herself when depression brings

you down. They can encourage you to follow your treatment plan, exercise,eat a healthy diet, and

generally take care of self . You can also join a support group for people with depression for the chance

to talk to others who understand what you're going through.

Sleep Well

Getting plenty of rest every night is a must for your mood. Senior citizens with depression often

Have noticeable sleep disturbances - they either sleep too much or not enough. Go to bed and

wake up on a regular schedule.

  Enjoy the Emotional Benefits of Exercise

Exercise offers physiological benefits that can help people going through depression. Physical activity

relieves stress and can make you feel great. Plus, the satisfaction you get from finishing an engaging and

challenging workout can boost your self-esteem as you get stronger and more physically fit. When you

fight depression with a regular exercise routine, you’ll feel better emotionally and physically.

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How can we help someone with depression?

If you know someone who has depression, first help him or her see a doctor or mental health

professional. Several ways you can help an older adult with depression is to:

Offer support, understanding, patience, and encouragement.

Help keep track of his or her appointments, if possible because many older adults with

depression may not be thinking clearly.

Try to make sure he or she has a way of getting to doctor visits.

Talk to him or her, and listen carefully.

Never ignore comments about suicide, and report them to your loved one’s therapist or doctor.

Invite him or her out for walks or outings, or to engage in indoor activities with you.

Remind him or her that, with time and treatment, the depression will lift.

Treatment of Geriatric Depression

Just as depression has no single cause, no one treatment works for everyone. Finding the

right depression treatment often takes time. The treatments are given below;

Antidepressant medication

Electroconvulsive therapy (ECT)

psychotherapies

social activities

Physical exercise and music therapy.

Recreation

Avoid isolation. Make quality time with others a priority.

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Move your body frequently—don't sit for more than an hour

Be careful with alcohol. It can interfere with meds and worsen depression.

Get the sleep you need. Take daytime naps if insomnia is a problem.

Typical treatment involves a combination of therapy, medication, and lifestyle changes.

Lifestyle changes used to treat depression include:

Increasing physical activity

Finding a new hobby or interest

Having regular visits with family and friends

Getting enough sleep daily

Eating a well-balanced diet

Therapy

An Institution

An institution is a  place where old people can live together and be cared for when they

are too weak or ill to take care of themselves. It is meant for senior citizens who are unable to

stay with their families or are destitute. Nowadays both husband and wife do job in most of the

families. So sometimes it may happen that they get less time to look after old people but it

doesn't happen always. Sometimes old people may feel neglected. The place is of course like

home where the inmates get all the facilities for a routine living, like food, clothing, and shelter.

All these necessities are well looked after but, the much-needed love, and care of loved ones is of

course sadly missing.

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At least in India till now, the old people staying away from the home, from their children,

or left to themselves is not considered to be a very happy situation. This concept of separating

the elders from the youngsters has been imported into India from the West. However, for the

West it may not be so heart rending for, there; it is their original life style that two generations

never stay under one roof. But, in India where, for centuries, not only two but also even three

generations have lived together.

It is the breakup of the system of the joint family and the introduction of a nuclear family

that has brought this unhappy situation enter our society, and the institutions have had to come

up to cater to the needs of the senior citizens. Besides this, since the women have started working

out of homes, there is now, no one to look after the routine needs of the elders at home. Also

with the women working out come their attitudes towards the elders, for, today, the working

women do not take the elders as their duty but as useless appendages in the family. This attitude

of the women has also largely contributed to the removal of elders from families. This inability

may lead one into neurotic depression. Depression is a state of low mood and aversion to activity

that can affect a person's thoughts, behavior, feelings and sense of well-being. Depressed people

feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, hurt, or restless.

They may lose interest in activities that once were pleasurable, experience loss of appetite or

overeating, have problems concentrating, remembering details, or making decisions, and may

contemplate, attempt, or commit suicide. Insomnia, excessive sleeping, fatigue, loss of energy, or

aches, pains, or digestive problems may also be present Perception is the organization,

identification, and interpretation of sensory information in order to represent and understand the

environment.

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Facilities of the institution for the senior citizens

Institutions for senior citizens should have calm, pollution free environment and all

other basic necessities just as any comfortable housing project. It could be located in a rural

or urban setting depending on the type of people expected to live in it. While some people

may like quiet idyllic surroundings, others may prefer an urban area where they have quick

access to facilities in the city. Old Age Homes could be the dormitory type, independent

rooms or cottages depending on the social and economic status of those who are going to

live in the homes. The rooms should be well-ventilated. As much as possible all facilities

in the home should be at the ground floor level. If upper floors have to be built then a

sloping ramp has to be provided which would also facilitate easy passage of wheel chair

when needed. The toilets and bathrooms should have rough flooring so that the elders do

not slip. Suitable railings should be provided for support.

A room should be set apart where sick people needing short-term treatment could be

housed. Recreation rooms and rooms for medical care should be built. A home for the aged

will need an administrator who will be responsible for the running of the home. Supporting

staff such as clerks, cashier cum accountant, nursing staff, attainders, maids and a cook are

the basic required staff for the efficient running of an old age home.

A medical officer will be needed to attend to the health needs of the inmates. If the

home is very close to a hospital where emergencies can be treated then, it may be enough

to avail the services of a Doctor, who works there part-time. A nutritionist can play an

important role by providing special attention to the nutritional requirements of the

residents. At least a part-time nutritionist should be appointed. A professionally qualified

social worker and a counsellor are essential members of the team of personnel. Wherever

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possible nursing staff and health care workers trained in Geriatric care should be appointed.

Recreational and reading facilities such as, televisions, video players, newspapers

and books should be available. Depending on the extent of the physical activity of the

residents other facilities for active sports such as: tennis, table tennis, squash can be

provided. In today's context computers with internet connections are more a necessity than

an option especially to receive and send e-mail to the near & dear. The ability to browse

the world wide web will allow the residents to be informed and mentally active.

Why the Institutions for senior citizens are increasing in India?

In India, parents are considered as next to God. Here, people respect their parents so much that

they consider it a sin to disobey them. Indian parents expect their children to look after them in old age.

When their son gets married, they are overjoyed by the arrival of the daughter in law, feeling more

secure and comfortable. Most of the Indian families take good care of their elders but unfortunately

there are people who treat their parents as liabilities making them feel neglected. Hundreds of

organizations are working to make life easy for destitute parents by developing old age homes in India.

Of course, there are rare cases when parents themselves prefer the privacy of old age homes but in the

majority of cases, it is the cold attitude of children that forces parents to move to these homes.

Being in a nuclear family, the new generation today does not get enough attention,

affection, care and concern from their parents. Deprived of these, they become more selfish,

stubborn, less concerned and careless. In olden days, children used to spend a lot of time with

their family. They used to depend on our parents and elders for suggestions and advises. They

used to sit down with them and talk about our different views and discuss each other and settle

the issues. With the introduction of neuclear family, communication gap between the inmates of

a family arised. There are so many reasons for this attitude such as generation gap, influence of

advanced technology, peer pressure and so on.

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In India the institutions are increasing in number day by day. These are helpful for the

elder people and the inmates are taken care of, by the concerned authorities by looking after their

all needs very well. We have to think why these institutions are getting increased in the country

like India, where we have altogether different culture and traditional values when compared to

Western countries. In most of the Western countries the culture is different. The children become

independent and they leave home once they attain the maturity to have their own life leaving the

parents at their places and Government looks after these people. But in India we have a tradition

and culture where by the children are not treated as a grown up ones and their all needs are taken

care of till the time they complete their studies and start earning. For this the parents leave no

stone unturned in their lives and they make lot of sacrifices to make their children successful

adults in their lives. Generally the girl child after finishing her education and becoming a

responsible citizen leaves her parents place for her in laws place after her marriage where she

takes care of the boy’s family including the parents of the boy! Similarly when the boy becomes

responsible adult he gets married to a suitable girl and she enters the boy’s home and takes care

of the family along with the parents. Here though the parents are no more active physically as

they were because of their old age, but their respect, dignity and regards in the family is

maintained and they act as decision makers in all important events happening in the family! That

is what the role of old parents they have in a typical Indian home. But unfortunately today we

can see many old people coming from good back ground and who have their own children, living

in these Institutions. They are capable of paying the expenses to the Institutions as they have no

dearth on money. Some other reasons are given below;

Because of the following reasons, elderly people take the painful decision to move to these

homes.

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Sometimes grown-ups fail to realize their duty and are so much engrossed in their

personal lives that they feel  it a burden to keep the parents with them. They feel it as

interference in their personal lives and eventually tell their parents that they cannot keep

them.

The ego clash between mother-in-law and daughter-in-law causes too much stress in the

house and the situation comes at such the worst that they cannot live together.

New generation is becoming more materialistic and their attitude towards parents is

changing. They seem to have lost their patience.

It’s not an easy decision for the parents. But, they have to move to these houses when

they can no longer tolerate the insult or they are told by their stone-hearted children to

leave the house. Old age home is their last resort.

Joint family system has completely dismembered and single family system has

proliferated. It is true in the single family system, aged parents have no place.

In the metros, old age people cannot be accommodated since there is no adequate space

to accommodate them.

Increasing cost of medical expenses. We have no government sponsored affordable care.

Young people are more sensuous and they consider old age people as a hindrance or

burden for their enjoyment.

The world is turning into a faster world, where in the younger generation is struggling hard to cope up with. Certainly, the aged people have no role to play here.

Relevance Institution for senior citizens

Many factors are accountable for the separation of old persons.

Youngsters have migrated to different places distant from their inhabitant places and also to numerous countries abroad. So they are unable to provide accommodation to their parents in their

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own houses even if they desire.

Many elders are also reluctant to provide the duty of household, which they are controlling for an elongated time, to children.

Youngsters are sometimes indignant in behavioral attitude to their parents.

Elders sometimes are too debilitated or ill to take care of themselves or get medicinal help in any urgent situation.

Elders who have been in control of the household for a long time are unwilling to give up the responsibility to their children.

Youngsters on their part are sometimes resentful of the attitude of their parents.

Elders are sometimes too incapacitated or unwell to look after themselves or get medical care especially in an emergency.

All these have made the Institutions for senior citizens seem more relevant in the Indian context than ever before.

Types of Institutions in India

Free Institutions

One is the "Free" type which cares for the destitute old people who have no one else to care for them. They are given shelter, food, clothing and medical care.

Paid Institutions

The second type is the "Paid" home where care is provided for a fee. Nowadays, such "Retirement" homes have become very popular in India and they are well worth considering.

Legal protection of senior citizens in India

Ageing is a natural and universal fact. It was always perceived as just a phase of life like,

childhood and youth. The responsibility of caring for the elderly is traditionally that of family

and most often by children. But due to rapid socioeconomic transformation elderly people are

left alone, by their family members, to take the challenges of life. However, with a growing trend

towards nuclear family set up and the associated decay of the extended family structure, the

vulnerability of the ageing population is increasing. India is a land where age and wisdom are

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traditionally respected. Elderly people, in developing and developed countries, have complex

problems in every walk of life. The existing legal provisions are not adequate to protect and

promote the basic and fundamental rights of elderly people.

Rights of Senior Citizens

The document ‘UN Principles of Ageing’ (1982) is considered the basic guideline for promotion

of the rights of senior citizens.

The five principles are :

1.  Independence

Older persons should have access to adequate food, water, shelter, clothing and health care

through the provision of income, family and community support and self-help. Older persons

should have the opportunity to work or to have access to other income-generating opportunities.

2.  Participation

Older Persons should remain integrated in society and participate actively in the formulation of

policies which effect their well-being.

3.  Care

Older Persons should have access to health care to help them maintain the optimum level of

physical, mental and emotional well-being.

4.  Self-Fulfilment

Older Persons should be able to pursue opportunities for the full development of their potential

and have access to educational, cultural, spiritual and recreational resources of society.

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5. Dignity

Older Persons should be able to live in dignity and security and should be free from exploitation

and mental and physical abuse.

UN Principles for senior citizens

1. Senior Citizens should have access to adequate food, water, shelter, clothing and healthcare

through the provision of income, family and community support and self-help.

2. Senior Citizens should have the opportunity to work or to have access to other income-

generating opportunities.

3. Senior Citizens should be able to participate in determining when and at what pace

withdrawal from the labour force takes place.

4. Senior Citizens should have access to appropriate educational and training programmes.

5. Senior Citizens should be able to live in environments that are safe and adaptable to personal

preferences and changing capacities.

6. Senior Citizens should be able to reside at home for as long as possible. Participation

7. Senior Citizens should remain integrated in society, participate actively in the formulation and

implementation of policies that directly affect their wellbeing and share their knowledge and

skills with younger generations.

8. Senior Citizens should be able to seek and develop opportunities for service to the

community and to serve as volunteers in positions appropriate to their interests and capabilities.

9. Senior Citizens should be able to form movements or associations of older persons Care

10. Senior Citizens should benefit from family and community care and protection in accordance

with each society’s system of cultural values.

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11. Senior Citizens should have access to healthcare to help them to maintain or regain the

optimum level of physical, mental and emotional wellbeing and to prevent or delay the onset of

illness.

12. Senior Citizens should have access to social and legal services to enhance their autonomy,

protection and care.

13. Senior Citizens should be able to utilize appropriate levels of institutional care, providing

protection, rehabilitation and social and mental stimulation in a humane and secure environment.

14. Senior Citizens should be able to enjoy human rights and fundamental freedoms when

residing in any shelter, care or treatment facility, including full respect for their dignity, beliefs,

needs and privacy and for the right to make decisions about their care and the quality of their

lives.

15. Senior Citizens should be able to pursue opportunities for the full development of their

potential.

16. Senior Citizens should have access to the educational, cultural, spiritual and recreational

resources of society.

17. Senior Citizens should be able to live in dignity and security and be free of exploitation and

physical or mental abuse.

18. Senior Citizens should be treated fairly regardless of age, gender, racial or ethnic

background, disability .

Advantages of an Institution

Joint Family System is disintegrating in our Society nowadays, thereby leaving the senior

citizens out of the fold. It is where Institutions steps into giving soothe to the senior citizens in

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their day to day life. There are some people taken advantage of the institutions and joins their

parents. But at other end it will be place of meeting same age groups and it will be the place for

those who don't have anyone to take care. 

The institutions are an advantage for people who are neglected by their children. Both

husband and wife may be working or not but their attitude towards elderly people should be

respectful, caring, and affectionate. Elderly people expect kindness from the younger lot, they

are also very sensitive and if they have any health problems that should be taken care of

patiently. Having institutions for the senior citizens is no doubt very good. When senior citizens

are neglected by their own family members, they have no one to go to, they can look towards the

Institutions. At an age, when they need care and support, they are left alone by their own

children. At such phases of life, they can go to old age homes and find people who have similar

family responses. This way, they can make friends there and at least forget their sorrow for some

time. Old age homes can be made a happier place for the aged by letting the people from outside

interact with the old people and make them happy in their own ways.

1. These institutions have special medical facilities for senior citizens such as mobile health care

systems, ambulances, nurses and provision of well-balanced meals. So they can live a healthy

life.

2.    Good services and good behavior of the staff, food being palatable and wholesome are the main

advantage of such institutions.

3.    Apart from food, shelter and medical amenities, it is also provides access to telephones and

other forms of communication so that residents may keep in touch with their loved ones.

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4.    The entertainment and library facilities are also available for the sole purpose of the senior

citizens.

5.    For senior citizens who have nowhere to go and no one to support them, these institutions

provide a safe haven. These homes also create a family like atmosphere among the residents.

Senior citizens experience a sense of security and friendship when they share their joys and

sorrows with each other.

6.    In the Institution, old people have a lot of free time, so they can utilize it creatively.

7.     They usually do not have to work in the institution to earn and do not have lot of duties to

perform.

8.    They can also pursue any hobbies in a very peaceful atmosphere.

10.  They have the freedom to pursue and participate in religious activities.

11. Senior citizens can live peacefully and healthily in the institution.

12. Kerala government provides counseling services to senior citizens in the institutions

Disadvantages of an Institution

There both advantages and disadvantages of having institutions for senior citizens. Because, if

there is no one to take care of them, then they are having at least one place or other to live

peacefully. But if these homes are increasing then it is an alarming situation. Because only if

elderly people begins to search for these types of homes, new homes will opened. This happens

because young ones are not ready to take care of their parents. If there is only few institutions

taking care of those who really don't have anyone to take care then it is needed.

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People generally staying here are very sad. It is but natural for them to be so as they leave

their well-known homes for stranger place that lacks in all memories.

It is natural for them to fear institutions as it is known to be prior step to death. Seeing

that they will not be able to get back to their homes, it can be deemed true.

Main problem that one faces here is loneliness. Few residents here get visits from

families after long time and these are very few in nature.

Independence becomes a thing of past when one enters these homes. Many see it as the

end of their lives. With independence all gone, they even bid goodbye to their self-

esteem. All they live their lives in is scheduled activity.

Missing element here is freedom. What is given to them for meals is final. They do not

have any say in it.

After getting permission only can watch TV

They do not even have independence to go for worship at place of their option. They are

not even allowed to have personal doctors. All they get is one’s at home.

Anger at putting them in these homes directed at their children is a natural thing for these

residents. Family is bound to get various heartaches from these.

Wayanad District

Wayanad District came into existence on 1st November, 1980 as the 12th District of Kerala

consisting of Mananthavady, Sulthanbathery and Vythiri Taluks. The name Wayanad is derived

from Vayal Nadu which means the land of paddy fields. It is situated at a height between 700 meters

and 2100 meters above the sea level nested among the mountains of the Western Ghats on the

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Eastern portion of North Kerala and on the sides of Tamil Nadu and Karnataka States. The District

was carved out from the then Kozhikode and Kannur Districts. About 885.92.sq.km of area is under

forest. The culture of Wayanad is mainly tribal oriented. Though considered as backward, this

District is perhaps one of the biggest foreign exchange earners of the State, with its production of

cash crops like pepper, cardamom, coffee, tea, spices and other condiments.

History

In ancient times the land was ruled by the Vedar Rajas. Later Wayanad came under the rule of

Pazhassi Raja of Kottayam Royal Dynasty. The modern history of the district is associated with

the events that took place during the Mysorean invasion and the long spell of the British rule

stretching over a period of about two centuries. There was fierce encounter between the British

and Pazhassi Rajah. When the state of Kerala came into being in 1956, Wayanad was a part of

Cannannore district; later in 1957 south Wayanad was added to Kozhikode district and north

Wayanad remained with Cannannore district.

People

One important characteristic feature of this district is the large adivasi population,

consisting mainly of Paniyas, Kurumas, Adiyars, Kurichyas, Ooralis, Kadans, Kattunaikkans.

Kattunaikkans are the different original tribes of Wayanad. The Kurichyar is the most developed

among them. They are small land owners, whereas the members of other tribes are mostly

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labourers. Wayanad district district stands first in the case of adivasi population (about 36%)

among other districts in the state.

Wayanad has a large settler population. There are people from almost all parts of Kerala

who migrated to this fertile land for building up their lives. Wayanad has a small Jain community

consisting Gowdas who came from Karnataka. Almost all sections of Christianity are well

represented. One fourth population of Wayanad is constituted by Christians. Muslims constitute

another one fourth population and rest of the population belongs to Hindus. Their hard work and

scarifies helped them to prosper. On the other hand, the last few decades have seen the complete

marginalization of the indigenous people.

Conclusion

A large number of senior citizens are often abandoned by their own kith and kin and left

to rot in old age homes. However, there is also another side to the coin. There are also a sizable

number of men and women who are forced to take the decision of leaving their parents in old age

homes, because their parents leave them no other choice with their attitude and behaviour. We

humans, as we have so often heard, are social animals. We live in families unlike other animals

who go separate ways from their parents after they grow up, we generally still care for them, till

the end of their lives. At least it is true to a large extent in India. However, in this social setup,

we often come across individuals who care nothing for family or relationships. For them, their

wants and needs have to be satisfied, by any means. The life span of human beings is marked

by successive change of events beginning from gestation and ending in death through successive

periods of infancy, childhood, adolescence, adulthood and senescence. The process of growth

starts with the uterine life and ends around twenty years post natal life when all linear increments

of the body stop and the internal organs fully develop. Almost a decade later, the body starts

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losing all vital capacities gradually and it is believed to be the onset of ageing. Parents are a

treasure that children should guard zealously. Putting them into old age homes must never be the

first but always the last option. Treat your parents as assets not liability. Let them feel wanted

and not a burden.

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