Cultural practices in India towards healthy ageing

Journal of Geriatric Care and Research 2014, Vol 1, No 1 Review Cultural practices in India towards healthy ageing Raveesh B N Abstract Culture involves sharing values, traditions and lifestyles within a group or community. The study of culture contributes to our understanding of human behavior and mental processes. Culture changes continuously and dynamically through the generations in response to environmental demands. Culture affects the construction of clinical reality in five ways: 1. Culture-based subjective experience. 2. Culture-based idioms of distress 3. Culture-based diagnosis 4. Culture-based treatment and 5. Culture-based outcome. In India it used to be common for couples to have large families in order to ensure survival and care of the elderly. Economic conditions support the cultural values which greatly influence family size. The Indian Vedic inscriptions gave deep thoughts to the problems of old age and evolved a social order, which provided security and respect to the elders. The Upanishads cryptically and the Puranas at length support the four-fold ashram system. The Smritis of Manu and others describe the ashram and Varna systems in their religious instructions. A society is most likely to increase in vitality, prosperity and strength, when the beliefs, institutions and individuals by which it is ruled, join to offer fair levels of respect, security, education, opportunity, liberty and peace to people at all of its levels. Cultural adaptation, changes in customs and traditions, reinforce genetic adaptation to promote lifestyles which are thought to enhance health. This paper tries to utilise this old knowledge to a wholesome form that can be adapted for recent times. Key words Culture involves sharing values, traditions and lifestyles within a group or community. Our customs are the ways in which we do things in our everyday life. Often these are determined by tradition, or the historical ways we have developed of doing things. People who share a culture tend to associate with each other. The degree of commitment to cultural values varies from person to person and is particularly influenced by age, gender, social layer and peer group influences. 2 Health implications of culture In many cultures health is not attributable to human intervention but is seen as an act of God or spirits. Cultural adaptation, changes in customs and traditions, reinforce genetic adaptation to promote lifestyles which are thought to enhance health. In India it used to be common for couples to have large families in order to ensure survival and care of the elderly. Economic conditions supported the cultural values of which influenced family size. Unwanted isolation appears to be a common problem for many elders, irrespective of cultural background. Traditional cultural practices do not negatively affect the health and functioning of older individuals.3 Old age & Indian culture The Vedic rishis gave deep thought to the problems of old age and evolved a social order, which provided security and respect to the elders. On one hand dharma (religion) emphasized worship and service of the parents and grandparents with love and reverence and on the other the elders were encouraged to leave their homes to become Vanaprasti and Sanyasins and specific duties were laid out for them.4 Hindu Culture, Health, Aging Introduction This is truly the age of ageing. We are on the leading edge of a demographic and health revolution which will globally reshape almost all aspects of life, such as perceptions of the life cycle, the organization of health care systems; intergenerational relations; the nature of family life; the structure of communities and attitude towards death.1 The ancient Indian texts about the way of life (Ayurveda) explain the method of rejuvenation treatment which is like another nectar, having incomprehensible miraculous effects, promoting life span, providing health, sustaining youthfulness, relieving sleepiness, drowsiness, exertion, exhaustion, lassitude and debility, restoring equilibrium of the doshas, bringing stability, alleviating laxity of muscles, kindling the internal fire and producing of excellent luster, complexion and voice". 5 The objectives of life Dharma are: - one's duty unto oneself, to the family, society, and nation i.e. one's duty 2 Journal of Geriatric Care and Research unto humanity which includes, Artha: - Reaping of the benefits of duty. Kama: - Satisfaction of desires and Moksha: - Attainment of salvation. A healthy long life is essential for the achievement of these four fold objectives which are achieved by the principles of Niyama and Yama wherein, Niyama consists of cleanliness, contentment, austerity, study, and self-surrender to God and Yama consists of nonviolence, truthfulness, nonstealing, chastity or celibacy, and the nonreceiving of gifts.6 The qualitative and quantitative balance of the seven basic tissues (dhathus) is essential for maintaining the body in a healthy condition.7 In our life span we need to consider the following three stages: 1. Childhood: - The time of maximum nourishment, in which the nourishment of the dhathus takes place. 2. Middle ages: - The generative and degenerative process balances each other in this period. 3. Old age: - In the period of ageing, the degenerative process overrides the generative process. Indian preventive medicine is called Svasthavrtta 'establishing oneself in good habits', and its main principle is that one must reject excess in everything. Harmony and health are possible only when everything in life is enjoyed at the proper moment in the proper amount. Indian medicinal practice proposes three stages in the quest for good health.5,8 1. Daily routine and seasonal activities to prevent illness. Daily and seasonal routines try to ensure that the body's needs are satisfied no matter where the mind may roam, since most people are unable to develop this perception which is necessary to know what is happening within their bodies. Neither activity nor rest should be excessive, the body requires moderation in all things. A healthy routine establishes moderation and order in both body and mind. Examples are, to awaken before sunrise, to evacuate bowels and bladder after awakening and to bathe every day to create a sense of bodily freshness and Exercise moderately (preferably Yoga). 2. Purification therapy and medications for diseases Even after strictly following the above mentioned precautions, it is natural that some toxins may accumulate in the body as a result of various metabolic activities. It is necessary to eliminate these toxins from the body, which the body would be producing to a great extent. But some toxins may still remain in the body and may cause many diseases when their quantity increases beyond a certain limit.9 To maintain proper functioning of different body systems and to stay healthy, a regular elimination of these toxins is required. Indian system gives an elimination therapy called ‘Panchakarma’. 3. Rejuvenation of the system to enhance health and quality of life. Another important factor for maintaining good health and staying active even in the old age is called the rejuvenation therapy. So a healthy person should take rejuvenating preparations to maintain good health and stay young. There are many such preparations available, which can be taken according to the season and ones personal constitution. Good social conduct, morality, good manners and good character are some other factors, which are necessary to stay away from diseases. Thus the Indian system of medicine approaches the complete individual while giving instructions about maintaining the health which in turn helps towards healthy ageing of an individual. Discussion Enough is told of periods in which societies grew to prosperity to acquaint us with the wisdom that favours such growth. A society is most likely to increase in vitality, prosperity and strength when the beliefs, institutions and individuals by which it is ruled, join to offer fair levels of respect, security, education, opportunity, liberty and peace to people at all of its levels. The way we think about health and disease is culturally shaped. As Stewart points out, "The bio-medical model one-culture system of North American health care service is based on the assumption that one can take a piece of a person and mend it, without reference to the whole person, much less the social environment."10 Good health means more than the absence of disease or illness but rather emphasizes the whole person and the harmonious functioning of body, mind, emotions and spirit. 11 This view of health is only now coming to be accepted by the modern health care establishment which was recognized long back in the cultural practices of India which help in health ageing. Conclusion "Ageing well has the same basic meaning regardless of a person's cultural background." Civilization – is not what our ancestor has given but also what we follow, maintain & gift to our younger generation. There is richness in Indian cultural practices which at least are modified to modern day conditions so that the basics of healthy living are maintained. "To Age well is to feel whole." A scientific appraisal of such cultural practices can throw light about its importance in modern health care. Author information: Raveesh B N. MD, MSc, LLB, PGDMLE, PGDMLS, PGDHR, MBA, Professor & Head, Department of Psychiatry, Mysore Medical College & Research Institute, Mysore India. Correspondence: Dr Raveesh B N. Department of Psychiatry, Mysore Medical College & Research Institute, Mysore, 570001, India. Email: raveesh6@yahoo.com Competing interests: The author has declared that no competing interests exist. © 2014 The Author and GeriCaRe. 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