MALAYSIA: Looking Through the Eyes of the Aged

KUALA LUMPUR, Malaysia (Bernama), July 3, 2006: "Have we ever really given a thought about our aged parents, looked at their wrinkled faces and reflected on how we would fare when we reach their age, asks Melati Mohd Ariff in a feature published today. As patience turns to anger when trying to endure the "antics" of our eccentric grandparents, do we pause to think and show compassion and understanding for them instead? To some, getting old is frightening and they are ready to spend huge sums of money "to find their fountain of youth". Plastic surgeries, food supplements and special injections are much sought after to keep them "young". The reality is, we cannot evade the "sunset" years even if we get to live long enough. Senior Citizens The Health Ministry categorises senior citizens as those aged 60 years and above while the World Health Organisation (WHO)'s definition is 65 years and above. "The age limit for Malaysia's senior citizens is lower as we want the term to cover more people, in line with the government's policy," Hospital Permai Johor Baharu consultant psychiatrist Dr Norazam Harun told Bernama recently. He said the number of senior citizens in the country had increased from 5.7 per cent of the population in 1990 to 6.3 per cent or about 1.4 million in 2000. "In the year 2020, when Malaysia hopes to achieve the developed nation status, the projection is some 3 million senior citizens, about 10 per cent of the estimated 32 million population," he added. Globally, the 2002 statistics showed there were 635 million senior citizens aged 65 and above, making up about 10 per cent of the total world population. By 2050, this number is expected to magnify to about 30 per cent of the total population. There are more senior citizens in developing countries such as China (230 million), India (142 million), Indonesia (29 million), Brazil (27 million) and Pakistan (18 million) while the facilities and needs of the silver-haired population are not given due emphasis compared with developed countries. Increasing Life Expectancy At the same time, Dr Norazam said life expectancy also increased as health improved tremendously, especially in developed nations. On average in Malaysia, life expectancy for men had increased from 65 years (1990) to 70 years (2000) and for women, from 68 (1990) to 76 (2000). "Not only is life expectancy increasing, the number (of aged) is also growing. This is one of the worries of the impact of the 'baby boomers' with a jump in birth rate, especially in the United States after the Second World War. "Those who were born at that time and if they're still alive, are in the senior citizens category. With the sharp increase, WHO is focusing more on this group of people worldwide and on how to deal with their health problems," said Dr Norazam. Effects of Getting Old Even though ageing is a natural process, getting old is still seen as life's complex mystery and it also impacts our bodily functions. "There are several theories why human beings age. One of which relates to the genetic factor, something that has been programmed. For example, the number of times a cell multiplies and replaces old cells, that has been coded in the genetic programme. Let's say a person is programmed for 60 years and upon reaching that age, his activity graph decreases. This cannot be changed," explained Dr Norazam. Another theory attributes ageing also to the impact of toxins in the environment or food consumed. Toxins available naturally are in the form of free radicals or chemicals, for example, cigarette smoke that can cause premature death of cells. This will also cause rapid ageing. Two Changes According to Dr Norazam, ageing brings about physical and psychological changes. Physical changes involve both inward and outward changes, among which, skin becomes less elastic, and eyesight and hearing becomes poor (50 per cent of senior citizens suffer from poor eyesight and 34 per cent have hearing problems). Senior citizens also suffer from slow digestion, constipation due to less water absorption, weak heart beat and they tire easily, besides having poor expansion of lungs that prohibit them from strenuous activities. Their muscles will weaken and they easily suffer from arthritis or joint pains (30 per cent of senior citizens have mobility problems). Physical Changes Dr Norazam said physical changes differed from one individual to another. "Maybe a person is 80 years old but looks healthier and younger than a person who is 65. This may be due to factors of genetic, diet and how active the person was when he was younger. "For a person who is active when he was young and continues to be active after retirement, the chances of him getting the illnesses associated with ageing are lesser as he is healthier and fitter. "It's the same with those who still use their minds for critical and analytical thinking. If they actively read or their jobs involve studying they will also age less as they are still using their brains," he elaborated. With regards to those who worked, then stay idle after retirement, Dr Norazam said such people lived in isolation and would eventually be bored stiff and suffer from multiple diseases, besides depression. "But if they continue to be active, meet new friends and embark on new activities, this will help them lessen the impact of ageing." Psychological Changes On psychological changes, he said it involved one's own thinking and others' perception. "Normally, when a person retires, he thinks that this is the time for him to rest after years of toiling. "Such an attitude will make him prone to illness. Some people use the age factor to stop learning and attending courses. This is actually a mistake. Learning is a life-long process." On others' perception that also contributes to psychological changes in senior citizens, he said: "The children usually have this mentality that their aged parents need not do anything anymore. "They will do all the work. Aged mothers need no longer cook. Either the children dislike their cooking as it is not as tasty as before or they do not want the kitchen to be messed up." Such an attitude, he said, was not healthy for the parents but detrimental in the long run. "Children normally tell their aged mothers to just sit around. So,when they come from the village and stay with their children in the city, they will get bored and decide to return home," he added. Depression And Anxiety "Senior citizens do get depressed," affirmed Dr Norazam. "Depression has two peaks. One is during puberty and the other when people age. So an elderly gets depressed not only when his loved ones die but also when he thinks of his own impending death. And the more he thinks about his wild, younger days, the more afraid he becomes. His guilty conscience will cause anxiety." Another phenomenon associated with ageing is the 'empty-nest syndrome'. This happens when the children have grown up and ready to leave the family home in pursuit of a career or after getting married. The ageing parents will face loneliness and boredom. They will have problems in adapting, especially if they have been too dependent on their children. Five Diseases Senior citizens are always associated with five diseases -- stroke, heart disorders, pneumonia, arthritis and infection. "Besides that, there are five conditions or the five 'i' which can signify other diseases that affect their health and well-being," said Dr Norazam. First is 'immobility' due to arthritis, heart disease or stroke. Second, 'instability' which means self-instability, for example, feeling drowsy when getting up which causes the person to fall or has blurred vision. Third is 'intellectual impairment' which means less thinking ability. Fourth is 'incontinence', which means inability to control the urge to urinate or defecate. Fifth, 'iatrogenic' or problems with medicines; whether it's the effect of the medicines or interaction with other medicines. "Maybe the medicines are not suitable and when consumed, cause dizziness or make them more tired and sleep all the time. The children may perceive this in a wrong way and label their parents as lazy" explained Dr Norazam. Facing Reality Being young once, and then getting old, sick and die. This is what life is all about. But what matters most is for people to lead a healthy and quality life. "Good health, financially-sound, comfortable home and nutritious diet should be considered long before one gets old. All these need to be planned when we're still in good health and young like the saying, prepare an umbrella before it rains because when it pours, it'll be just too late," advised Dr Norazam. He said children should have undivided love for their parents and this feeling must be nurtured from young. "Children must also be taught to respect their parents and care for them just like what their parents had done for them when they were young. Caring for the parents when they are old and sick should be the responsibility of all children. We should care for our parents when they're still alive and if we do good things for them, our children will emulate our good deeds. This is a fact of life. If we're unable to care for our parents, it's best and appropriate to find a maid to look after them or find them a good nursing home," he said. Such a move, he added, was more humane than leaving old and sick parents all by themselves. "We should prevent any abuse on senior citizens whether directly or indirectly. The caring family concept should be instilled among all family members." Copyright © 2006 BERNAMA All rights reserved.