Active ageing

ACTIVE AGEING PROGRAM

NEW DELHI, GURGAON

MISSION AND VISION OF DFI

• THE AIM OF THE DEVELOPMENT AND IMPLEMENTATION OF ACTIVE AGING MODEL IS TO EMPOWER COMMUNITY DWELLING ELDERLY FOR CHRONIC DISEASE PREVENTION AND CONTROL AT THE COMMUNITY

• TO EVALUATE THE MORBIDITY PROFILE OF THE YOUTH AND ELDERLY

• TO FIND OUT THE IMPACT OF ACTIVE AGEING MODEL ON

QUALITY OF LIFE IN ELDERLY PEOPLE.

• OPPORTUNITIES TO PERMIT OLDER ADULTS TO HAVE PRODUCTIVE SOCIAL PARTICIPATION, AND UTILIZE THEIR RESOURCES IN COMMUNITY DEVELOPMENT PROGRAMS.

POPULATION AGEING

INDIA HAS AROUND 100 MILLION ELDERLY AT PRESENT AND THE NUMBER IS EXPECTED TO INCREASE TO 323 MILLION, CONSTITUTING 20 PER CENT OF THE TOTAL POPULATION, BY 2050

(UNITED NATIONS POPULATION FUND (UNFPA) AND HELP AGE INTERNATIONAL).

•URBANISATION• NUCLEARISATION OF FAMILY•MIGRATION•DUAL CAREER FAMILIES

PROBLEMS IN ELDERS: CAUSES

STRESSORS

(HEALTH AND SOCIAL PROBLEMS OF THE ELDERLY: A CROSS-SECTIONAL STUDY IN UDUPI TALUK, KARNATAKA.A LENA, K ASHOK, M PADMA,1 V KAMATH, AND A KAMATH)

ELDERLY CARE MODELS IN INDIA:

• VERY LITTLE EFFORT HAS BEEN MADE TO DEVELOP A MODEL OF HEALTH AND SOCIAL CARE IN TUNE WITH THE CHANGING NEED AND TIME

1. OLD AGE HOME2. ASSISTED LIVING3. RECREATION CENTRE

• OPPORTUNITY FOR INNOVATION IN SOCIAL SYSTEM DEVELOPMENT, IS A MAJOR CHALLENGE.

ELDERLY CARE MODELS IN INDIA:

• ELDERLY SUFFER FROM MULTIPLE AND CHRONIC DISEASES.

• THEY NEED LONG TERM AND CONSTANT CARE.

• THUS A MODEL OF CARE PROVIDING COMPREHENSIVE HEALTH SERVICES TO ELDERLY AT ALL LEVELS OF HEALTH CARE DELIVERY IS IMPERATIVE TO MEET THE GROWING HEALTH NEED OF ELDERLY.

(NATIONAL PROGRAMME FOR THE HEALTH CARE OF THE ELDERLY (NPHCE) AN APPROACH TOWARDS ACTIVE AND HEALTHY AGEING ,OPERATIONAL GUIDELINES, DIRECTORATE GENERAL OF HEALTH SERVICES MINISTRY OF HEALTH

& FAMILY WELFARE GOVERNMENT OF INDIA)

SOLUTION • ELDERLY ACCESS TO AGE-FRIENDLY AND

AFFORDABLE INFORMATION AND SERVICES

• AGEING IN PLACE

ACTIVE AGEING

• ACTIVE AGEING IS THE PROCESS OF OPTIMIZING OPPORTUNITIES FOR HEALTH, PARTICIPATION AND SECURITY IN ORDER TO ENHANCE QUALITY OF LIFE AS PEOPLE AGE.

• IT APPLIES TO BOTH INDIVIDUALS AND POPULATION GROUPS

ELDERLY : A VALUABLE RESOURCE IN COMMUNITY

• IT WOULD BE INTERESTING TO UTILIZE THE ELDERLY MANPOWER RESOURCES IN THE NEXT YEARS TO REVIEW COMPLEXITY OF ELDERLY ISSUES.

• THE TALENTS OF AN ELDER, WHO HAS EXPERIENCE AND TIME, CAN BE UTILIZED AS THE MANPOWER RESOURCES BRINGING ABOUT CHANGES IN COMMUNITY.

AGEING IN PLACE: ACTIVE AGEING

• ACTIVE AGEING DEPENDS ON A VARIETY OF INFLUENCES OR DETERMINANTS E.G. PHYSICAL ,ENVIRONMENTS, SUPPORT SERVICES, ECONOMICAL AND SOCIAL SITUATIONS

• IN TERMS OF INDIVIDUAL PERSPECTIVE, THE THREE BASIC PILLARS OF ACTIVE AGEING ARE FULL PARTICIPATION IN SOCIOECONOMIC, CULTURAL, SPIRITUAL AND CIVIC AFFAIRS, ACCORDING TO BASIC HUMAN RIGHTS, CAPACITIES, NEEDS AND PREFERENCES.

OUR WORK TILL NOW

DECEMBER 2009-SEPTEMBER 2013

INAUGURATION OF ACTIVE AGEING PROGRAM IN

DECEMBER 2009

ADOPTION OF 4 LOCAL ELDER ORGANIZATION

1.RREWA (GURGAON)

2.EFFORTS GROUP (SAFDURJUNG ENCLAVE),NEW DELHI

3.MATRI MANDIR (SAFDURJUNG ENCLAVE) NEW DELHI

4.VARISHTHA NAGRIK KENDRA SANSTHA (CHATTARPUR)NEW DELHI

METHODOLOGY: ACTIVE AGEING

1. SELECTION OF VOLUNTARY MEMBERS OF 4 ORGANIZATION WHO COULD TAKE THE RESPONSIBILITY OF A LOCAL SUPERVISOR S

2. WORKSHOPS FOR ELDERS ON PREVALENT CHRONIC DISEASES

3. DISSEMINATION OF INFORMATION THROUGH TEXTBOOKS/MANUALS

• SELECTION OF LOCAL SUPERVISORS AMONGST ELDER (SELECTION PROCESS LEFT ON SENIORS OF THE ORGANIZATION)

• SELECT MEMBERS FROM THE ORGANIZATION(ACTIVE OR INACTIVE)

• EACH LOCAL SUPERVISOR TO TAKE CARE OF 10 ELDER MEMBERS

• WORKSHOPS ON CHRONIC HEALTH AND SOCIAL ISSUES

UTILIZE THE CONCEPTS OF ACTIVE AGEING, ON SELF CARE, MUTUAL HELP, AND SELF PROMOTION.

ARRANGE SOCIAL INTERACTION IN SMALLER GROUPS WHERE LOCAL SUPERVISORS TO CONDUCT EXERCISES/RECREATIONAL ACTIVITIES/DISCUSSIONS

Group Activities

MOTIVATE ,FOSTER MORE LOCAL SUPERVISORS

TECHNOLOGY IN ACTIVE AGEING HAS BEEN ONE OF THE ACTIVE RESEARCHES DONE GLOBALLY.

TECHNOLOGY HAS BEEN PROVEN TO FIND SUSTAINABLE SOLUTIONS THAT WILL HELP EASE THE TRANSITION OF AGING POPULATIONS

INTRODUCING TECHNOLOGY AND ACTIVE AGEING

• COMMUNICATION AND ENGAGEMENT THROUGH COMMUNICATION TECHNOLOGY

MOBILE PHONES, INTERNET, CHAT, E-MAIL, WEB SURFING, FACEBOOK, AND SMARTPHONES FORM PART OF DAILY LIFE.

• 2. SAFETY AND SECURITY (HOME HEALTHCARE MONITORS)

MOBILE PERSONAL EMERGENCY RESPONSE SYSTEMS PASSIVE FALL DETECTION SYSTEMS , SENSOR-BASED HOME MONITORS WEB CAMERAS

3.HEALTH AND WELLNESS

PRODUCTS DESIGNED FOR COGNITION ,BALANCE IMPAIRMENTS, WITH NINTENDO’S WIIFIT, X BOX ETC

FOR CHRONIC DISEASE MANAGEMENT, REMOTELY MONITORING DIABETES OR CONGESTIVE HEART FAILURE. OVER TIME, INTEGRATION OF THESE WITH HEALTH SYSTEMS’ (ELECTRONIC HEALTH RECORDS)IN HOSPITALS CAN BECOME STANDARD PROCEDURES IN HEALTH SYSTEMS.

4. LEARNING AND CONTRIBUTING THROUGH EDUCATION TECHNOLOGY

TELEVISION, INTERNET SURFING: INFORMATION ON CULTURE, HEALTH, SPIRITUAL, POLITICS

ELDER REMAIN ACTIVE IN AND KNOWLEDGEABLE ABOUT SOCIETY, CONTRIBUTE TO IT THROUGH VOLUNTEERING OR BY LEAVING A LEGACY OF STORIES AND SHARED GENEALOGY FOR THOSE WHO LOVE THEM.

CASE STUDY

ACTIVE AGEING VNKS, CHATTARPUR EXTENSION, NEW

DELHI2011-2013

OBJECTIVES

• TO CREATE NEW MEANINGFUL PARTNERSHIPS IN OTHER AREAS OF INDIA TO CREATE MORE SERVICE PROVIDERS, EDUCATIONAL PROGRAMS AND MEDICAL CENTRE’S LINKED WITH ASSOCIATIONS OF LOCAL ELDERS

• MULTI SECTORAL NGOS OF ELDERLY CAN BE LINKED WITH LOCAL GOVERNMENT FOR COMMUNITY INITIATIVES

345 ELDER MEMBERS OF VNKS CHOSEN FOR STUDY

• PATRON OF COMMUNITY ELDERS OF VNKS WERE INTRODUCED BY DFI TO THE DEPARTMENT OF SOCIAL WELFARE AND EMPOWERMENT, NEW DELHI.

• THE ACTIVE MEMBERS OF VNKS WORKED RELENTLESSLY TO ADVOCATE WITH LOCAL GOVERNMENT FOR CHATTARPUR EXTENSION TO BE AGE FRIENDLY.

THE MAIN FOCUS WERE ON ROADS, WATER WORKS AND STREET LIGHTS WHICH WERE HAZARDOUS FOR ELDERS CAUSING MOBILITY IMPAIRMENT DUE TO UNFRIENDLY ENVIRONMENT

2011

ROADS, WATER WORKS, ELECTRICITY REPAIRED THROUGH EFFORTS OF VNKS IN COLLABORATION WITH LOCAL MLA

2013

ON SEPTEMBER 11TH 2013, INAUGURATION STONE OF AN OLD AGE HOME WAS LAID BY THE MINISTER OF

SOCIAL WELFARE AND EMPOWERMENT OF DELHI

AT CHATTARPUR EXTENSION

DFI HAS SET UP A WELLNESS CLINIC FOR THE ELDERS AT THE VNKS OFFICE.

DFI HAS INTRODUCED STUDY ON TECHNOLOGY

TO IMPROVE POINT OF CARE TESTING ,BALANCE AND DEPRESSION, PAIN, RESPIRATION

WITH INTRODUCTION OF THE ACTIVE AGEING PROGRAM AT CHATTARPUR EXTENSION ENCLAVE THE DFI UTILIZED THE INEXPLICABLE RESOURCE OF THE ELDER MEMBERS OF VNKS THROUGH SELF CARE, MUTUAL HELP AND SELF PROMOTION

STUDY ONE

USING INTERNATIONAL CLASSIFICATION OF FUNCTIONING TO UNDERSTAND ATTITUDE OF COMMUNITY DWELLING ELDERLY TOWARDS

COMMUNICATION AND EDUCATION TECHNOLOGY IN NEW DELHI, INDIA

USING INTERNATIONAL CLASSIFICATION OF FUNCTIONING TO UNDERSTAND ATTITUDE OF COMMUNITY DWELLING ELDERLY TOWARDS COMMUNICATION AND EDUCATION TECHNOLOGY

IN NEW DELHI, INDIA.ICF category Facilitator

Satisfied Neither satisfiednor dissatisfied

Dissatisfied

495-100%

351-95%

226-50%

14-25%

-14-25%

-226-50%

-351-95%

-495-100%

Communication Technology (e125)

37.7% 10.3% 8% 29% 11.3% 1.7% 1.7% 0 0.3%

Education Technology(e130)

39% 10% 6.7% 28% 14% 1.6% 0.7% 0 0

• AMONG THE 300 PARTICIPANTS, 85% INDICATED THEIR DAILY LIFE WAS FACILITATED BY COMMUNICATION TECHNOLOGY (MOBILE PHONES, INTERNET CALLING, TELEVISION, COMPUTER)

• 83.6% REPORTED THAT THEY BENEFITED FROM EDUCATION TECHNOLOGY (E.G., CAPTURING INFORMATION ON HEALTH/EMPLOYMENT/CURRENT AFFAIRS THROUGH COMPUTERS)

FUTURE STUDY (WITH APUHC-UNSW)

• UTILIZE A USER-CENTRIC APPROACH AND WORKING CLOSELY WITH ELDERS TO DESIGN A MOBILE PHONE-BASED APPLICATION TO SUPPORT AGED CARE.

• EVALUATE IMPACT OF TECHNOLOGY ON ELDERS’ PHYSICAL, SOCIAL AND MENTAL HEALTH.

STUDY TWO

SMART BREATHE: PROCATOR, SWEDEN

N=35 elders

N=16 FemalesN=19 Males

Duration of Study-3 months

RESULT OF STUDYCLINICAL OUTCOMES

• Hypertension• Diabetes• Respiratory

disorders

RESULT OF STUDYQUALITY OF LIFE

• BETTER SLEEP• BETTER APPETITE• DISCIPLINED LIFESTYLE• SOCIAL INTERACTION • ENERGETIC• CARING AND RESPONSIBILITY TOWARDS

OTHERS

RESULT: SF-36(Quality of Life)

PHYSICAL FUNCTIONI

NG

ROLE LIMITATION

DUE TO PHYSICAL HEALTH

ROLE LIMITATION DUE

TO EMOTIO

NAL PROBLE

M

ENERGY/FATIGUE

EMOTIONAL

WELL BEING

SOCIAL FUNCTIO

NING

PAIN GENERAL HEALTH

91 86 79 83 84 85 68 81 67 90 85 87 86 83 70 84

STUDY THREE

04/15/23 46

Low-Cost Center-of-Gravity Biofeedback For Static Posturing - Smart Mirror

04/15/23 47

IMBALANCE AND FALLS IN ELDERLY

Increasing age Poor vision

Diabetes Low Grip

Arthritis Strength

Low socio-economic status

(Veuas et al; 1997)

49 04/15/23

•CREATE AWARENESS ABOUT ELDER PROBLEMS.•FALLS DUE TO IMBALANCE IN ELDERS.•INTRODUCE TECHNOLOGY TO PREVENT FALLS IN ELDERS.•VALUABLE FUTURE LEARNING OF THEIR OWN LIFE.

OBJECTIVES OF HIGH SCHOOL WORKSHOP

04/15/23 50

PROJECT TEAM• STUDENTS INVOLVEMENT

– MR. RISHABH SEHGAL• UNDERGRADUATE INTERN, ELECTRONICS & COMMUNICATION ENGG.,

NATIONAL INSTITUTE OF TECHNOLOGY HAMIRPUR, INDIA

– 5 HIGH SCHOOL STUDENTS– ROOHI KAPOOR– SACHIN SETHI– MRIDUL KHANNA– HIMANSHU KHANNA– ADITYA CHOPRA

• SAMPLE SIZE: 75 ELDERS

• DURATION OF STUDY 2 YEARS

• OBJECTIVE : RISK OF FALL IN FALL IN ELDERS

04/15/23 55

PROJECT TEAM EXPERIENCESMR. RISHABH SEHGAL: SUMMER INTERNSHIP WITH PROJECT ADVISOR–DR. ANIRBAN DUTTA, RESEARCH SCIENTIST, DEMAR-LIRMM, FRANCE (VIDEO DEMONSTRATION AT HTTP://WWW.YOUTUBE.COM/WATCH?V=EES9T2RTA_S)

POINT OF CARE TESTING

FUTURE STUDY: PREVENTIVE HEALTHCARE

CONNECTING COMMUNITY DWELLING ELDERLY TO HEALTHCARE FACILITIES THRU TECHNOLOGY

STUDY FOUR

EFFICACY OF GROUP BASED EXERCSIES IN COMMUNITY DWELLING ELDERLY

DIABETIC PATIENTS

PURPOSE TO SIGNIFY THE EFFECT OF GROUP BASED

EXERCISES IN IMPROVING QUALITY OF LIFE IN COMMUNITY DWELLING ELDERS WITH DIABETES.

METHODOLOGY AREA OF STUDY• VARISTHA NAGRIK KALYAN SAMITI,CHATTARPUR AND SAFDARJUNG LIBRARY CUM

RECRATIONAL CENTRE FOR ELDERLY (NEW DELHI)

SAMPLE SIZE-• 34 elderly,(6 female ,28 males)

DURATION OF STUDY-• 2 MONTHS

OUTCOME MEASURE-• BBG AND SF-36

DURATION OF SESSION-• 45 MINS TWICE A WEEK.

EXERCISE PROTOCOL

1. RELAXED DEEP BREATHING EXERCISES(3 MINS)

2. RANGE OF MOTION EXERCISES FOR BILATERAL ANKLE JOINTS(5 MINS)

3. FUNCTIONAL BALANCE TRAINING• SIT TO STAND(5 TIMES)• STANDING WEIGHT SHIFT(5 TIMES)• FUNCTIONAL REACH SIDEWARDS AND ANTERIOR FOR TOUCHING TARGET SET BY

THERAPISTS(5 TIMES)• BIPEDAL HEEL RAISE(20 SECONDS)

• UNIPEDAL STANDING FOR 15 SECONDS(5 TIMES)

• UNIPEDAL STANDING FOR 15 SECONDS WITH KNEE BENDING(5 TIMES)

4. WOBBOLE BOARD TRAINING (6 MINS)

5. GAIT TRAINING• TANDEM WALKING (5 MINS)• SPOT MARCHING(5 MINS)

RESULTS (Balance and Blood Sugar)SUBJECTS PRE-

INTERVENTION BBG

PRE-INTERVENTION GLUCOSE

POST-INTERVENTION BBG

POST-INTERVENTION GLUCOSE

1 36 170 40 166

2 51 165 51 164

3 53 154 54 155

4 52 164 54 168

5 50 159 53 145

6 48 142 51 134

MEAN 48.3 50.5

Balance Blood Sugar

RESULTS (Quality of Life)ANALYSIS BERG

BALANCE SCALE

SF-36PHYSICAL HEALTH

SF-36ROLE LIMITATION DUE TO HEALTH PROBLEMS

SF-36ROLE LIMITATION DUE TO EMOTIONAL PROBLEMS

MEAN Pre-39.8Post-46.2

Pre-43Post-58

Pre-19.4Post-45

Pre-39.8Post-46.2

DEGREES OF FREEDOM

4 4S 4 4

t STAT -3.78439934 -2.070196678 -1.447321271 -3.784399334

P(T<=t)ONE-TAIL

0.009681078 0.053603133 0.110681412 0.074141741

t CRITICAL ONE-TAIL

2.131846782 2.131846782 2.131846782 2.131846782

RESULTS (Quality of Life)ANALYSIS BERG

BALANCE SCALE

SF-36PHYSICAL HEALTH

SF-36ROLE LIMITATION DUE TO HEALTH PROBLEMS

SF-36ROLE LIMITATION DUE TO EMOTIONAL PROBLEMS

MEAN Pre-39.8Post-46.2

Pre-43Post-58

Pre-19.4Post-45

Pre-39.8Post-46.2

DEGREES OF FREEDOM

4 4S 4 4

t STAT -3.78439934 -2.070196678 -1.447321271 -3.784399334

P(T<=t)ONE-TAIL

0.009681078 0.053603133 0.110681412 0.074141741

t CRITICAL ONE-TAIL

2.131846782 2.131846782 2.131846782 2.131846782

RESULTS(Quality of Life)ANALYSIS SF-36-

ENERGY/FATIGUE

SF-36-EMOTIONAL WELL BEING

SF-36-SOCIAL FUNCTION

SF-36-PAIN

SF-36-GENRAL HEALTH

MEAN Pre-43Post-60

Pre-47.8Post-56

Pre-55Post-75

Pre-52.5Post-79

Pre-46Post-68

DEGREES OF FREEDOM

4 4 4 4 4

t STAT -4.54344 -1.2085 -6.53197 -4.53638 -5.047146145

P(T<=t)ONE-TAIL

0.005235 0.146705 0.001419 0.005263 0.003622796

t CRITICAL ONE-TAIL

2.131847 2.131847 2.131847 2.131847 2.131846782

DISCUSSION

THE ABOVE RESULTS DEFINE THAT THERE WERE CHANGESELDERS PARTICIPATING IN GROUP EXERCISES IN NEIGHBOURHOOD COMMUNITY CENTRES HAVE IMPROVED THEIR QUALITY OF LIFE.

PERIODIC, RESULT ORIENTED MEETING/SOCIALIZING OF ELDERS HAVING SIMILAR PROBLEM, IN THIS CASE DIABETES SHOWED IMPROVEMENT IN SOCIAL FUNCTIONS, EMOTIONAL WELL BEING AND GENERAL HEALTH .

CONCLUSION :ACTIVE AGEING

• ACCESS TO THE ENTIRE RANGE OF HEALTH AND SOCIAL SERVICES THAT ADDRESS THE NEEDS AND RIGHTS OF OLDER ADULTS; AND PROTECTION, DIGNITY AND CARE IN EVENTS THAT OLDER ADULTS ARE NO LONGER ABLE TO SUPPORT AND PROTECT THEMSELVES.

(ACTIVE AGEING AND INDEPENDENT LIVING SERVICES: CORE PROPOSITIONS LEADING TO A CONCEPTUAL FRAMEWORK MARK LEYS, SOFIE DE ROUCK VRIJE UNIVERSITEIT BRUSSEL,

(SMIT-MESO) )

CONCLUSION..CONTD• EXERCISES ARE PROVEN TO BENEFIT CHRONIC NON

COMMUNICABLE DISEASE LIKE DIABETES ,THEREFORE DECREASES RISKS OF CARDIAC, BRAIN STROKE, NEUROPATHY ETC

• GROUP EXERCISES OF ELDERS HAVING SIMILAR PROBLEM, MAKES A BETTER COMRADESHIP AND UNDERSTANDING AMONGST ELDERS.

• GROUPS OF ELDERLY SOCIALIZING WITH A SIMILAR PURPOSE , IS AN IMPORTANT COMPONENT OF ACTIVE AGEING FRAMEWORK WHICH IMPROVES QUALITY OF LIFE IN ELDERS.

CONCLUSION..CONTD

• WE HOPE WITH INTRODUCTION OF THE ACTIVE AGEING PROGRAM, DFI CAN UTILIZE THE INEXPLICABLE RESOURCE OF THE ELDER POPULATION IN INDIA THROUGH SELF CARE, MUTUAL HELP AND SELF PROMOTION.

• OUR FUTURE PROPOSAL IS TO CREATE RESEARCH MODELS NEEDS IN THE COMMUNITY TO UNDERSTAND BEST PRACTICES FOR COMMUNITY CARE AND IMPROVEMENT IN QOL OF THE ELDERLY IN INDIA.

CONCLUSION..CONTD

• RESEARCH ON TECHNOLOGY TO ENCOURAGE ACTIVE AGEING IN INDIA SHOULD BE ENCOURAGED, FOR FUTURE ELDERS OF THE COUNTRY.

• WE MUST BE SERIOUS ABOUT THE WORK OF BUILDING CARING PROGRAMS, TRAINING HELPERS, AND INCREASING SELF CARE AMONG WE WHO, SOONER OR LATER, WILL NEED SUCH ASSISTANCE.

THANK YOU