As in most other western countries, the population in New Zealand is aging. The elderly share in the total population in NZ has trebled from 4 % in 1901 to 12 % in 1999. This means that there is now a vital need for elderly care and maintaining the life quality of elderly people in this country. The increase in life expectancy in New Zealand has been particularly steep in recent years. From 1991 to 2005, the increase for males has been 5 years and for females 3.2 years with a current average life expectancy of 77.9 years for males and 81.9 years for females.
We have definite expectations from old age, which don’t always match the realities. Our attitudes towards aging are conditioned by contemporary paradigms of efficiency and active enjoyment of life.
We often hear phrases such as: “Life starts after retirement” which is one of the frequent clichés in advertisements of retirement schemes and lifestyle blocks.
While we can expect to live longer than our parents and grandparents, while our life span has increased, this is not necessarily true when it come to our quality of life. It is interesting that we become older but don’t seem to be healthier than previous generations in this country and that GPs waiting rooms in NZ are crowded with patients over 65.
In this presentation I want to address the most frequent diseases, elderly people experience and highlight the role Ayurveda can take in managing and improving the wellness of the elderly population.
We are definitely becoming a society, which is facing more and more chronic diseases in old age. Almost 75% of all people over 65 suffer from at least one chronic illness. 50% of them have at least 2 chronic diseases. The most common conditions are hypertension, dementia, respiratory diseases and over weight. The other common conditions may be heart attack, stroke and diabetes. Most of these conditions are related to life style and this is where Ayurveda is relevant as it focuses on improving life style as the primary method of creating wellness.
Ayurveda bases its methods on the three biological forces called Vata, Pitta and Kapha. Vata is the principle of movement. It is charactrrized by dry, rough, mobile qualities and which controls functions such as the physical movement, movement of the food, circulation, activities of the mind, neurological processes. Pitta is the principle of metabolism, characterized by hot, sharp, fluid qualities, which govern all processes of digestion, hormones etc. Kapha is the principle of stability. It is characterized by heavy, oily and slow qualities, which lubricate joints, strengthens tissues and provides immunity. In old age, the principles of Pitta and Kapha such as metabolism and immunity become weakened and Vata takes on a predominant role through the increase of dry, mobile and rough qualities in the body and the mind. Through these principles Ayurveda understands the degenerative processes that take place in the body and the mind during old age.
There are certain physiological changes, which are common in old age and responsible for the degenerative diseases. If we understand these processes we will be able to identify methods of supporting the functioning of the systems and preventing diseases.
The most definitive changes during old age are the decrease of the Basal metabolic rate or metabolism, which in Ayurvedic terms is a depletion of the metabolic fire “Agni”. Simple practices such as drinking warm water instead of cold water or drinking ginger tea on an every day basis will help to increase the metabolism.
In old age the water proportion in the skin drops, making the skin dry and prone to irritation. A practice of applying warm oils such as sesame oil or sunflower oil on a regular basis helps moistening the skin, improves the circulation, maintains flexibility of the joints and brings the person back in touch with him-or herself, which is self nurturing and the key in wellness.
The body’s capacity to process oxygen diminishes in old age. This results in difficulties related to respiration. Ayurveda suggests Pranayama a Yogic breathing practice, which expands lung capacity, calms the mind and increases the body’s oxygen carrying capacity.
In the ageing body, muscle mass decreases and fat increases. According to some studies on ageing, being bed ridden for 15 days can make a person biologically older by 10 years. If we consider the sedentary life styles older people tend to have in rest homes, a huge chance for agility is lost. By practicing Yoga, which is not merely a physical exercise, but also nourishes the mind, older people could achieve greater flexibility, groundedness, improved digestive functions and increased mental capacities. Yoga is ideal for older people. If you think of such common events as hip fractures, which can lead to complications and even death; these are often caused by low bone density. More importantly hip fractures occur due to falls. Yoga not only increases the bone density by its endurance building postures but also improves the body’s ability to maintain postural balance, both of which can drastically reduce the risks for injury.
The other processes, which are affected in old age, are an increase in bad cholesterol (LDL), poor insulin absorption predisposing to cardio vascular diseases and diabetes. The decrease of functioning neurons in the brain may lead to such conditions as Alzheimer’s, Parkinson’s disease and dementia. The shrinking of the Thymus gland reduces immunity. Hormonal changes take place in both men and women. Ayurveda is perhaps the first ever health system which addresses geriatric support through a specialized branch of knowledge called “Rasyana”. Rasayana can roughly be translated as ‘rejuvenation’. It takes into consideration life style principles, which bring about wellbeing at the levels of body, mind and spirit. Ayurvedic principles don’t only add years to life, but add life to years. This is exactly what is needed in elderly care.
Rasayana is one of the eight branches of Ayurveda, a Science that is both curative and preventative, promotes the concept of longevity through life style, nutrition, herbs and terapeutics. Rasa means sap, juice, prime part or essence. It promotes longevity as it slows the degeneration of the tissues. Rasayana can maintain health and also act as a therapeutic measure in diseases.
The three factors that influence wellness are Food – Ahara, Activities - Vihara and Thoughts and Emotions – Vichara.
Nutrition is the foremost strategy, Ayurveda considers in improving wellness. The individual’s attitude towards eating is the key for better digestion and absorption. Ayurveda recommends eating with awareness and eating fresh foods; in particular eating organic, food free of chemical sprays and seasonal foods. It is recommended to avoid genetically engineered and processed foods, reduce canned foods and to avoid frozen foods, instant foods and foods labeled ‘low fat’.
Hearing that, some might wonder what there is left to eat? This exactly is my point. Any food, which is not wholesome, should not be called food. In a recent study it was proven that communities where people live more than 100 years, are communities where people only eat fresh foods. Processed foods are an epidemic and very common amongst elderly people. The elderly communities seriously need education on wholesome foods and learn to see the connections between the highly processed foods and the increased incidences we face in cancers, such as bowel cancer.
Ayurveda recommends digestive spices such as cumin, coriander, fennel and turmeric to be added to every day cooking to make food more easily digestible and to improve the general state of health. Fatigue and low energy levels don’t need to be the realities of old age. Most of the fatigue and low energy is due to increased intake of stimulants such coffee, eating refined and processed foods, white sugar or sugar substitutes.
Ayurveda promotes the understanding that there is more to life than survival. It is in our old age when we have a chance to take the time to be creative. Ayurveda sees this as the spiritual dimension of ourselves, which are independent of religions or faith. Spirituality is related to recognizing the levels in us that go beyond the levels of the mind. Ayurveda recommends meditation for connecting to the inner self and thus realizing the interconnected nature of the human being with the rest of the universe. Regular routine, purpose in life and enthusiasm for the wider community can all send the message to the body and mind not to age. The saying: “Use it or loose it”, is the secret of not suffering from the effects of ageing.
Ayurveda has age-old methods of utilizing the wisdom of the plants to prevent the degenerative effects of ageing. Plants such as Haritaki, Bighitaki, Amalaki, Bramhi, Shatavari and Ashwagandha have been used for thousands of years to keep one young in old age. The validity of Ayurvedic support is immense in the care of the elderly as it does not contradict but rather complements the mainstream health care system. It is interesting how easily we tend to give away our self-support in wellness to medical systems and focus on illness rather than wellbeing. It would be wonderful to see a blending of Ayurveda and the mainstream health care system to utilize the best of