Significant Contributions of Older Women-by Nadira Gunatilleke
It is well known that the life expectancy of women exceeds that of men by almost four years according to the latest statistics. However, women spend approximately twice as many years disabled prior to death as their male counterparts, said Dr. Lasantha Ganewatta during an interview with the Daily News.
Excerpts:
Q: What are the most common health issues of older women?
A: Sri Lanka is one of the fastest ageing populations in South East Asia. It is well known that the life expectancy of women exceeds that of men by almost four years according to the latest statistics. However, women spend approximately twice as many years disabled prior to death as their male counterparts. The diseases that account for health care utilization are also the major contributors of their disability. Those are heart diseases, stroke, diabetes mellitus, high blood pressure, osteoporosis and related fractures, osteoarthritis and cancers, especially breast cancers. Not only that, there are other health issues unique to the ageing process including cognitive impairment and dementia, poor mobility, falls, bladder and bowel incontinence, medications related issues and depression. Frailty which is gradual loss of inbuilt reserve is commoner among females compared to males. You will understand the fact that the ageing process will lead to many diseases and disabilities among women.
Q: How can those health issues be solved?
A: We could discuss those strategies under two broad categories. Those measures include non-pharmacological and pharmacological. We, as health care professionals interested in geriatric medicine, encourage non-pharmacological measures as the mainstay of healthy ageing. This is because many of the health issues related to ageing do not have remediable medicines, on the other hand adding drugs to the prescription causes many disabilities to the elderly people compared to their young counterparts.
To prevent heart diseases and strokes it is important to control the associated risk factors mainly high blood pressure, diabetes mellitus and high cholesterol levels. Dietary modifications are fundamentally important specially low salt, less oily, low sugar and low starchy foods with high fibre content make you healthier. We encourage our older adults to consume more and more fruits, vegetables, pulses and legumes. Optimizing intake of proteins, calcium and Vitamin D enhances bone and muscle health. Fish, meat and dairy products provide those nutrients. Bone and muscle health is important to prevent osteoporosis and fractures. Not only that, it further improves the frailty.
Physical activity is one of the most important targets for promoting health in older women. It is one of the difficult areas to promote among Sri Lankan older women due to cultural and educational background. Physical exercises at least half an hour per day for five days per week will significantly lower the occurrence of heart disease and stroke by controlling the major risk factors. It also prevents bone loss and fractures, selected cancers, depression and obesity. Studies involving exercise interventions have found reduced risks for falls, improved strength, and improved function in older adults. Group exercise activities offer social advantages and group support for exercise maintenance, but home exercise can be better incorporated into daily schedules. However, we always advise older women to have their physician’s directions prior to beginning or continue physical exercises. If someone could not carry out exercises for 30 minutes, intermittent bouts of activity lasting as long as 10 minutes can be beneficial.
Adequate hydration is important to prevent infections, constipation, drug side effects and cloudiness of memory. Older women are advised to stay mentally active with adequate socialization and should be involved in the decision making process to overcome social isolation, depression and memory impairments.
It is important to have a safe environment in and around the residence to minimize falls and fall related fractures.
Finally, regular medical check-ups, clinic follow-up and adherence to drug treatment are important areas to gain healthy ageing for women.
Q: How can family members take steps to protect elderly women?
A: Firstly, family members could encourage the areas we discussed earlier to enhance the health of older women including providing healthy foods, creating a safe environment to do regular exercises, bringing them to the physician regularly and getting them involved in the decision making process.
Family members could help them clean and tidy their house. Falls are the number one cause of accidental death and injury for the elderly. Something as simple as removing a loose throw rug, moving an extension cord out of the way or storing piles of magazines in an out-of-the-way corner can significantly reduce senior falls. They can install grab bars if needed, especially by the toilet, bathtub and maybe the bed. These are inexpensive devices that can help prevent falls. One local programme in our community provides these free of charge and even installs them.
Encourage them to have their vision and hearing checked to promote communication ability, prevent falls and keep them cognitively sound. Research shows that a healthy social life can be a boon to senior health and longevity. We should make sure they are protected financially.
Abuse of Elders is a common problem specially among older women. They are being abused physically, verbally, psychologically, financially and even sexually. We observe many of them are neglected by their family or caregivers. Therefore, we should check on them frequently with a phone call, or better yet, in person.
Finally, we should explore their future plans and their will to ease some sensitive areas of life.
Q: Currently older women too face various economic hardships along with the entire country. How to avoid ‘accidents’, hospital stays and undergoing serious medical treatment which can be costly?
A: This is an important area we should focus on. With the economic hardship I would say the most affected group is older people. Older women are further vulnerable as they inherently try to live with minimum resources keeping other family members satisfied. With the very high cost of healthy foods, medicine, transport and aids and equipment family finds difficulties to look after them properly.
Therefore, it is necessary to find ways to prevent hospital admissions, accidents and disabilities. What we discussed in answer number 2 and 3 will be very helpful to prevent home accidents and to control their chronic illness to prevent medical emergencies like heart attacks, high blood pressures, strokes, law and high blood sugar values as well as infection. I would advise our older women not to take any over-the-counter medicine which may badly affect health including mobility and balance without your knowledge.
One should strictly adhere to falls prevention strategies to prevent fractures, especially hip fractures. Keeping a safe home environment as we discussed, adequate lighting, better vision and asking help when necessary are important areas of falls prevention.
Q: How can older women gain more mental strength to face the day-to-day challenges of their lives?
A: There are many ways that you could keep up their psychological well-being. Social interdependence is an important aspect.
Interdependence of various kinds, from various sources was identified as beneficial for mental health. Women are supporting and being supported by the husband, children, other family members, friends and the wider community. Community engagement often includes volunteering to keep them mentally active.
Feeling them valued also has a positive affect on their mental well-being. Feeling that one has made a meaningful contribution is particularly important. This could come from helping others and volunteering. Being appreciated also makes elderly women feel valued, whether it was love and attention from family, being sought out by grandchildren or friends or being paid attention and listened to by community members or health care professionals.
Most older women find physical activity as a mental health booster. Common activities include spanned gardening, walking, group classes and dancing. Physical activity is identified as part of taking responsibility for one’s health, a source of pleasure, a contributor to social contact and a means of overcoming challenging life experience. Good nutrition is important to enhance the mental health of older women.
Having faith or belief is also contributing to good mental health. Therefore, they should be encouraged to continue spiritual activities they believe.
Q: What type of healthy income generating avenues can they use without getting too tired and staying at home?
A: There are many ways that older women can earn money even without leaving the home. If you have adequate security and facilities, you may rent spare rooms of your residence. They can also be involved in freelancing services like writing and translation to earn some money. You could become a career coach if you have wealth of knowledge in your field. Home cooking is also a popular field among older women to earn money. You may be good at knitting, jewelry making and crafts. Older women could use those skills to generate income.
Gardening is also a good source of income. These activities will not only generate income but help boost the physical and psychological well-being of older women.
