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| LETTER TO EDITOR |
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| Year : 2019 | Volume
: 51
| Issue : 1 | Page : 38-39 |
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Elderly and health: Role of spirituality in Indian context
Bijaya Nanda Naik1, Mahendra M Reddy2, Srikanta Kanungo3
1 Department of Community Medicine, SVMCH and RC, Puducherry, India
2 Department of Community Medicine, Sri Devraj Urs Medical College, Kolar, Karnataka, India
3 Department of Preventive and Social Medicine, JIPMER, Puducherry, India
| Date of Web Publication | 13-Jun-2019 |
Correspondence Address:
Bijaya Nanda Naik
Department of Community Medicine, SVMCH and RC, Puducherry - 605 102
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ym.ym_21_18
How to cite this article:
Naik BN, Reddy MM, Kanungo S. Elderly and health: Role of spirituality in Indian context. Yoga Mimamsa 2019;51:38-9 |
Dear Sir,
In India, the elderly population is expected to increase from 8.1% (Census, 2011) to 11.2% by 2020. The elderly population are a very vulnerable group. Changes in socioeconomic and cultural structure such as urbanization, nuclearization of family, and migration have resulted in many social and mental health problems among the elderly. The process of aging has taken a toll on physiological functioning of the body. Increase in many age-related health problems such as noncommunicable diseases, poor vision, poor mentation, and decreased hearing has made the elderly disabled and brought feeling of a futile life. Lack of social and financial security for the elderly, loneliness, increased risk of health problems, perceived limited access to health-care services, and neglected attitude from family have poised the greatest challenge in the health care of the elderly (Dhar, Chaturvedi & Nandan, 2011). All these are the root cause of stress, depression, hopelessness, and suicidal tendency among the elderly in India. In India, nearly 15 million elderly live all alone, with about three-fourths of them being female. One in seven elderly lives in elderly homes. In India, nearly a quarter of the elderly are depressed. Depression not only leads to various health problems, but also negatively affects other health outcomes. India has enacted laws, policies, and programs to address the health-related issues of the elderly. Although the National Programme for Health Care of the Elderly (NPHCE) talks about the provision of promotive, preventive, curative, and rehabilitative health care of elderly starting from the primary care level, it is primarily confined to physical, mental, and social well-being (Hawks, Hull, Thalman & Richins, 1995). Under the NPHCE, elderly care has been envisioned to be inclusive in medical education and services and calls for capacity building among the family members and primary caregivers. However, spirituality has not been discussed as an inclusive part of elderly health care despite being considered as an important part of life by elderly population (Isaac, Hay & Lubetkin, 2016).
Modern medicine has gone beyond the physical functioning of the body toward the “mind–body axis. ”Spirituality, an important attribute of a sound body, is gaining importance, and much research is now focusing on spiritual health. The World Health Organization and its member countries are exploring spirituality as the fourth dimension of health (Chaves, Gil, Chaves & Gil, 2015).
Spirituality is a broader concept, generally associated with searching for the meaning and existence of life (Chattopadhyay, 2007). Spirituality has been defined as “Self-awareness; connectedness with self, others, and a larger reality. ”Spirituality is the self-introspection and reflection on one's meaningful life. It instills positive attitude, hope, understanding, happiness, and coping ability, thereby reducing stress and improving self-actualization. Spirituality is viewed as being cheerful, happily involved in day-to-day activities of life, enjoying the art, music, and beautiful nature, and an urge to contribute to make the living on earth better (Chaves et al., 2015). Dossey opined that spirituality must be a part of modern medicine which is regarded as an art of healing.
Literature has shown the relationship between spirituality and positive outcome of age-related health problems such as cardiovascular diseases, cancers, disease-related disability, chronic lung disease, and chronic pain. There is an inverse relationship between spiritual practice and mental health problems. The full-minded spiritual practice has been proved to reduce anxiety and stress. Spirituality has been implicated in positive health changes such as better communication, healthy diet, reversal of tobacco use, alcohol consumption, and improvement in emotional/psychological health (Iwamasa & Iwasaki, 2011).
Western literature reveals that majority of the patients want their treating physician to inquire about their spiritual needs, especially during terminal illnesses. A simple spiritual history has been proven to be working wonders like an intervention in health outcomes (Mane, 2016). It builds trust and better communication between the doctor and patient. Despite difficulties, physicians are in a unique position to encourage patients to adopt healthy behaviors through assessing their spiritual needs. Spirituality can mediate health promotion and prevention by incorporating the Health Belief Model (Pandya, 2016; Isaac et al., 2016). Hence, Isaac et al. believe that spirituality can serve beyond palliative care into primary health care. As cited by Chattopadhyay, about eighty medical schools in the USA offer courses in spirituality in their medical curricula (Puchalski, 2001).
Spiritual support helps severely ill patients cope with the disease with a positive attitude, and hence patients should not be deprived of the spiritual support whenever possible. Spirituality helps coping with the hardships/barriers attached with being diagnosed of chronic diseases by serving as a source of strength, resilience, and well-being. Spirituality has been implicated in restoring the fading well-being among older adults in India.
India is considered the warehouse of spiritual and cultural heritage and ancient wisdom. Most of the people, especially the elderly in India, believe or practice spirituality. This spiritual practice has been implicated in long and happy life, good social interaction and support, and less suffering from diseases by our forefathers (Verma & Khanna, 2013).
Spirituality should not be just confined as an end-of-life intervention but embedded into our holistic health-care delivery system as an integral part of health promotion in the current arena of healthful living and healthy aging. Spirituality should be considered an integral part of medical and paramedical curriculum as well as capacity building of health-care personnel. While providing holistic, comprehensive, and compassionate health care to the elderly, health professionals should think out of the box and consider about the spiritual dimension in their health message. However, care should be taken while discussing about spirituality with patients or encouraging elderly to practice spirituality as insensitive attitude may do more harm than heal.[10]
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Chattopadhyay, S. (2007). Religion, spirituality, health and medicine: Why should Indian physicians care? Journal of Postgraduate Medicine, 53 (4), 262.  |
| 2. | Chaves, L. J., Gil, C. A., Chaves, L. J., & Gil, C. A. (2015). Older people's concepts of spirituality, related to aging and quality of life. Ciência Amp Saúde Coletiva, 20 (12), 3641-3652. |
| 3. | Dhar, N., Chaturvedi, S., & Nandan, D. (2011). Spiritual health scale 2011: Defining and measuring 4th dimension of health. Indian Journal of Community Medicine, 36 (4), 275-282. |
| 4. | Hawks, S. R., Hull, M. L., Thalman, R. L., & Richins, P. M. (1995). Review of spiritual health: Definition, role, and intervention strategies in health promotion. American Journal of Health Promotion, 9 (5), 371-378. |
| 5. | Isaac, K., Hay, J., & Lubetkin, E. (2016). Incorporating spirituality in primary care. Journal of Religion and Health, 55 (3), 1065. |
| 6. | Iwamasa, G. Y., & Iwasaki, M. (2011). A new multidimensional model of successful aging: Perceptions of Japanese American older adults. Journal of Cross-Cultural Gerontology, 26 (3), 261-278. |
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| 9. | Puchalski, C. M. (2001). The role of spirituality in health care. Proceedings Baylor University Medical Center, 14 (4), 352. |
| 10. | Verma, R., & Khanna, P. (2013). National program of health-care for the elderly in India: A hope for healthy ageing. International Journal of Preventive Medicine, 4 (10), 1103-1107. |
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