A Qualitative Study of Nonagenarian Persons in Two Districts of Kerala

Abstract

Older persons are vulnerable sections in the population from many angles. They are the worst affected when disasters like floods and epidemics strike the society. The proportion of older persons in the age group of 80 years and above in the state of Kerala, 13 percent of the total population is comparatively higher than in other states. Among the elderly, the number of persons in the age group of 90-100, nonagenarians is also increasing . This subgroup of 90 plus in the population needs to be studied in the Kerala context as this is an emerging phenomenon. It is important to document their multi-disciplinary profile as part of the longevity studies. This could throw up a number of clues regarding longevity in a developing country context. The present study is an exploratory exercise with the objective to gather basic information about daily routine, food habits, support systems, overall quality of life and health conditions as well as availability of health services. Two districts were purposively selected for this exercise- Alleppey and Trivandrum. From each district, the 90 plus individuals were also purposively selected using a viva-voce method- based on information supplied by key informants in the community regarding presence of such individuals in the community. A check-list tool was designed for the in-depth interview by including the topics to be covered.

A well-structured and carefully followed daily routine is found among most of the respondents that we interviewed. Most people manage their daily routine all alone and they even manage that with their walking sticks. Close family members provided support to many individuals. A few, even those living with their wives have engaged a home nurse mainly to give a bath and for doing some minimum physical exercises. Most respondents reported orthopedic complaints which included knee pains, other joint pains, low back pain etc. One of the salient trends that we observed from the data as evident from the current trends in Kerala, is the higher load of Non Communicable Diseases. A number of respondents have diabetes, CHD, neurological problems etc. Surprisingly, many respondents have better eye sight and hearing although a few suffer from hearing loss. Many use Ayurvedic medicines for many of their problems especially for orthopedic complaints. They resort to oil massage for these complaints. Many manage minor ailments with home remedies because they do not want to disturb their family members.

The overall quality of life of the 90 plus individuals is found to be better than that is normally assumed. Some of them are found to be in good physical and mental condition and manage their own life without much support. People with better social and family support can manage their life and cope up with their problems. It appears that the social and family support in addition to a more structured life could have helped in prolonging and sustaining their life. Based on this exploratory study, we would suggest that the existing geriatric policy framework should give due attention to the issues identified here. There should also be special home-based care and support in addition to special hospital-based services.