Samarth Magazine

Extend Your Family. Enjoy Your Age! Volume 03 | Issue 03 (Bonus) | `100 COMPLIMENTARY ISSUE, NOT FOR SALE MAKING SENSE OF A INVEST SMARTLY, IDENTIFY YOUR CONFUSED WORLD pg 6 LIVE COMFORTABLY pg 69 PASSION pg 16 Get four print issues delivered to doorstep Whatsapp ‘SUBS’ to 8700 677 878



“FROM THE EDITOR Rekindling Optimism; Revisting Samarth Pledge” Asheesh Gupta If there is one word that face of Covid pandemic, lockdown and unprecedented captures what the past five loss/ grief all around us, it is time to revisit the pledge we years of “Samarth” have meant took, to bring nothing less than the very best to our elders. to all of us involved, it is this: This carefully curated collector’s edition is a celebration of Inspiring. all that we stood for yesterday, stand for today and going to fight for tomorrow. As a bunch of doers who thrive and flourish on the bond we share Last year has been tragic for plenty, relentlessly stressful with our elders, issue after issue for others (particularly senior citizens in our country) and my team and I scour hungrily for monotonous for all. Truthfully, right now, we are in the midst our light bulb moments. It can be of responding to circumstances as they are: sometimes a conversation with one of the imaginatively, sometimes pragmatically. Bigger challenges community members, or an arresting and change undoubtedly lie ahead. As we slowly emerge thought of having made a difference from this pandemic, technology is likely to play a particularly in their lives, the success stories instrumental role, in whatever happens next. Our members of our collaborations or letters were quick to adopt virtual platforms through which we from readers acknowledging the conducted “Samarth Milan: An informative and interactive community initiatives – all it takes for webinar” for over a quarter of a year and managed to stay a magazine to be built is for an idea connected. We initiated and successfully launched the to be born. And ideas we do have senior citizen help lines in various states and reached out in plenty. And that is exactly what to elders in times of their need during the lockdown. Even our anniversary issue is: a tribute to the local city chapters continued their monthly meetings everything that inspired us. through the use of virtual platforms. Samarth was started with a So be ready. Be seated. See how far we all have come simple mission to bring peace of together in the last few years as you read through the mind and happiness to elders and various sections of this edition revisiting and celebrating children who care for them. In the the best articles, insights, stories, inspirations, memories and spirit of the Samarth community members. My own inspirations are quite a few. Every day for the last 5 years, they have engaged me with their ideas, floored me with their diligence and struck me with their passion for the work we do at Samarth and all that it stands for. I am privileged to witness their commitment to serve you, bringing you this “Magazine” that you love – and they believe in. Allow me to introduce Team Samarth community, my greatest inspiration. Let us hope that our collective endurance of 2020 will usher in a colorful and constructive 2021. Asheesh Vol 03 | Issue 03 | samarth | 1

FROM THE EDITOR Gaurav सकं  प वही, आशाएं नई Agarwal Chief इस वष हम समथ की पाचँ वी ं वषगाठँ मना रहे ह।ैं यिद मंै इन वषो ं की सबसे बड़ी Operating उपलिध या िफर सीख कहूँ तो वो है 'ेरणा’  मैगजी़ न के अंकों को सजं ोने में मझु े और Officer मरे े सािथयों को सकै ड़ों विरठ जनों, िविशट यितयों, व सीिनयर िसिटजस के मुदद् ों से Geeta जडु े़ लोगों व सं थाओं से साझं ा करने का अवसर िमला | इन मलु ाका़ तो,ं बातचीत, सवषे णो,ं Nambisan वीिडयो कॉफरेसस इयािद मंे इतना कुछ जानने व सीखने को िमला, नये िवचार, नई Care Operations धाराएँ िमली,ं कछु परु ानी धारणाएँ बदलीं और बहतु बहतु नहे व ोसाहन िमला | इन Director वषो ं की चद खास यादों को नई सोच व रचनाओं के साथ िपरोकर हमने यह िवशेष अंक तयै ार िकया है | Dipti Sinha Care Delivery समथ कयूिनटी की थापना के पीछे हमारा एक ही येय था: ऐसा कछु करना िजससे Manager विरठ नागिरकों की खशु ी (happiness) व मन की शािं त (peace of mind) या कहें तो सखु और चनै मंे बढ़ोतरी हो | िपछले एक वष की घटनाओं न,े जब covid19 का भीषण Sonali कोप रहा और िजसमे न िसफ़ हमारी कयिनू टीस बिक पूरे िवव को एक अभूतपवू Mishra पैमाने पर शोक और हािन का सामना करना पडा़ , हमें भी अपने येय व िदशा का Care पुनवालोकन करने को बाय िकया | और हर बार जब मंै और मरे े सािथयों ने इस बारे मंे Development चचा की, हम इसी िनकष पर पहँचु े िक इस समय सीिनयर िसिटज़स के साथ हमारे काम Manager की पहले से भी अिधक ज़रूरत है | इन असामा य पिरिथितयों में कािशत यह अकं हमारे इस संकप का तीक है | Jaswant Rawat आज भी हम सब अपनी पिरिथितयों का मुकाबला करते हुए आगे बढ़ रहे हैं | Samarth यकी़ नन आगे और नयी चनु ौितयाँ भी आएगँ ी | पर मझु े लगता है िक हमारा िववास, हमारा Community Mentor संकप और हमारा आशीवाद इन पर हमेशा भारी रहेगा | हमारी अडैट करने की {kमता Vijaya असीिमत है | जब पनै डेिमक की वजह से लॉक डाउन करना पडा़ , घर से िनकलना, िमलना Seth जलु ना असंभव हो गया था, हमारे अनके बुजुग कयिू नटी मबें ज़ ने बखबू ी टेनालजी को Care अपनाया | हमारे समथ िमलनों में जहाँ पहले लोग वैयितक रू प से िमलते थ,े अब वचुअल Consultant लॅटफास जैसे जूम व गूगल पर िमलने लगे | यहाँ तक िक अनेक सदय जो पहले आ-जा नहीं पाने की वजह से िमलन मंे शरीक नहीं हो पाते थे, उनके िलए अय सदयों Raman Kapur से जुड़ना और आसान हो गया | हमारी समथ हे पलाइन ने हज़ारों कयिूनटी मंेबज़ की, Care Network जो लॉकडाउन के समय अिनवाय सेवाएँ व वतुएँ नहीं ात कर पा रहे थे, सहायता की | Manager तो अब तयै ार हो जाइए! इस अकं के मायम से उस याा, उस राते का िफर से आनदं Bijendra लंे जो हमने िपछले कछु वषो ं मंे साथ-साथ तय िकया है | मैं बीते पाचँ सालों के हर एक िदन Sheoran का आभारी हू,ँ िजसने मुझे एक नई सीख, एक नई रे णा, एक नया िम, एक नया साथी, Head – Care एक नये कायकता से आमना सामना कराया | यह मेरी और मेरे सािथयों की खशु िकमती Technology है की हमंे आप तक समथ मैगजी़ न पहँचु ाने का सुअवसर िमला और आपने हमारे यास को सराहा | यह यास जारी रहगे ा और हमारी भरसक कोिशश होगी की हम आपकी Rajiv Dubey- Director - अप{े kाओं पर सदा खरे उतर े| Projects आइये आगे बढंे़ और आशा करें िक २०२० में हमने िजस धैय का पिरचय िदया, वह २०२१ में नये उसाह के रगं लाएगा | आशीष

JJooiinn 30,000+ SSaammaarrtthh mmeemmbbeerrss iinn 110 cciittiieess 30,000+ 110 YFEEYFAXAXOOTMTMUUEEIRIRLLNNYYDD.. AyAyoossuutthhttooeeiiSSnnacacllmmuuddaaeerrttyyhhooffuuaarrmmffrriililiyeyennggddrroossw.w..... ss,, wwee iinnvviittee Please share the details and we will send them a Pmleeamsbeesrhsahripe athned dee-ctaarilds aonndyowuerwbeilhl saelfn,dabthseomlutaely free. membership and e-card on your behalf, absolutely free. Please whatsapp your details @ 887707006076778778878 PAlseasSeawmhaarttshacpopmymouunritdyemtaeilms b@er8, 7e7n0jo0y6g7re7a8t7b8enefits: ADsISaCSOaUmNaTrSthIcEomVEmNuTnSityI mTOemURbSer,I eVnOjoLyUgNreTaEtEbRenI eEfXitPs:ERT ADVICE DISCOUNTS I EVENTS I TOURS I VOLUNTEER I EXPERT ADVICE www.samarth.community TM wM -w80,wSou.sthaCmity 1a, Grutrhug.rcamom- 12m200u1nity TM MCa-ll8u0s, Soonu+th91C8it8y010, 6G9u9ru5g9r9am - 122001 Call us on +91 8800 699 599 PPlleeaasseeuusseetthheefofromrmtotroecreocmommemndenyoduyrofruier nfrdisenadnds manadil imt taoiluistatto us or whatsapp detals to +91 87006 77878 SPMSlaRaem.masaaerMrtutRhhsSCeC. oothmmemmfouurnnmiittyyt,o,MMre--c88o00m,,mSSooeuunttdhhyCCoiitutyyrM-f-rR11i,.,eGGnuudMrrsuuRagSgnr.radammm-a-i11l22it22t00o00u11s at MR. MRS. MNAR.ME MRS. MNAR.ME MRS. MNAR.ME MRS. NAAGME E PHONE NAAGME E PHONE NAAGME E PHONE ACGITEY PHONE ACGITEY PHONE ACGITEY PHONE CEIMTAYIL CEIMTAYIL CEIMTAYIL EMMRA. IL MRS. PHONE EMMRA. IL MRS. PHONE EMMAYILDETAILS: MNAR.ME MRS. PHONE MNAR.ME MRS. PHONE NAME NAAGME E NAAGME E MY DETAILS: ACGITEY ACGITEY NPAHMOENE CEIMTAYIL CEIMTAYIL PSHAOMNAERTH MEMBER NO. SAMARTH MEMBER NO.

Cover Design: Aarti Uberoi CONTENTS 6 Cover Story Making sense of a confused world Tide through this time and emerge stronger, resilient and find meaning in this world Interview 16 Identify your Health 19 Mind that fall passion Tips to avoid hip Interview with fractures Director of NISD Health 22 Dental care for Health 24 What’s in a older Adults bite? Preventative methods Benefits of for oral care regulating digestion 4 | samarth | Vol 03 | Issue 03

Health insurance 28 All you need to know about GSatdugdeyts Health Insurance Survey EDITORIAL 36 Developing Editor: Asheesh Gupta 24% service quality Associate Editor: Indrajit De standards for Contributors: Asheesh Gupta, Indrajit De, Senior living facilities in Shubha Chandrashekaran, India Saumya Pande, Sakshi Jain, Sushma Jain, Sanjay K Ojha, 38 Samarth Aarti Uberoi Survey DESIGN Designed by: Aarti Uberoi PRODUCTION & LOGISTICS Manager Operations: Rakesh Upadhyay Manager Logistics: Vijay Menon Asst Manager Production & Logistics: M.P. Singh Executive: Mohd. Ansari 76% 40 iHappiness OFFICE ADDRESS Index Published, Printed and Owned by Samarth Survey Life Management Pvt. Ltd. Published and Key insights of printed on their behalf by Asheesh Gupta. Published at D-278, Basement, Sarvodaya happiness quotient Enclave, New Delhi. Printed at Tara Art Printers Pvt Ltd., A-46-47, Sector-5, NOIDA, (U.P.) 201301 For any customer queries and assistance please write to [email protected] Other Sections Please recycle this magazine and remove inserts before recycling 01 From the Editor 48 Travel Vol 03 | Issue 03 | samarth | 5 58 Poems 68 Invest smartly, live comfortably 71 Financial abuse 75 Mind Benders 77 Technology & gadgets

COVER STORY COVER STORY Making sense of a confused world In the face of a global pandemic, lockdown, inexplicable loss and grief, how can one possibly remain positive, maintain sanity and find solace in the community at large? How can we together tide through this time and emerge stronger, resilient and find meaning in this world that seems to have lost its way? A few insights to help our readers find meaning and inspiration in life all over again. By Samarth staff Is life worth living, or even worth caring about, cuts step strife, and economic is it a meaningless deeply into the fundamental downturn etc. absurdity? How one differences among religions answers this question and philosophies. These On one hand, once the sets the stage for how (and differences were experienced enforced lockdown was lifted even why) one chooses to in a more pronounced by the Indian government live. Disagreement about version during the ongoing or even during it, one saw how to answer this question, crisis: global pandemic, series of social gatherings as and whether it is a question fundamentalism at the door if nothing is wrong (beach- going, playing sports, eating 6 | samarth | Vol 03 | Issue 03

COVER STORY in restaurants, encouraging How does one even Granularity applies to return to schools); on the begin to make sense of this time as there can be long other hand, one also saw a “confusion”? term aspirations, but the steady rise in the number of pace of change requires corona virus infections and It is easy to state that 50 short term quick responses multiple waves of pandemic years ago things were not so that may need to be quickly amid growing concern with bad and 50 years hence things implemented. social sheltering. may not be so bad. But for seniors, the golden question Granularity applies to The country witnessed remains; how do we maintain solutions as there may various protests including our sanity and emerge stron- be “small nudges” with the recent one from farmers ger in such an uncertain time. lots of experimentation against the recently introduced and learning. As senior farm bill sometimes these One of the role that Samarth citizens of this country, are protests in turn resulted in intends to play in eldercare is we aware or sensitive to loss of innocent lives and to observe the world around, the unique circumstances destruction of properties in do focused research, and offer affecting our selves and our local communities. insights that may have positive environment? This may be impact for our senior members something to ponder upon. We heard and read stories as well as other individuals, leaders, and organizations in 2. Begin with As senior the long run. But, lately, it has emotion, not logic citizens of been difficult to respond to, this country, or at least make sense of, this A close friend in the are we aware peculiar time, it is not always middle of a bitter dispute or sensitive clear what to suggest since kept trying to make to the unique many of our proven mental logical arguments for circumstances models seemed so insufficient. how to proceed. He finally affecting our Let us together explore some concluded that some selves and emerging alterative thoughts. disagreements are less environment? about logical blueprints 1. Be granular and more about emotional of many fellow Indians whose sensitivity. A research industries, firms and farms are Broad sweeping (e.g.,“new recently shared evidence devastated and downsized. normal”) truisms simply of higher rates of stress, Many of us couldn’t move don’t work and offer false anxiety, and depression quick enough into new market hope leading to cynicism. risk with the crises. The opportunities opening up: pandemic malaise that unemployment is at an all- Granularity applies to has affected many in the time high and so is the stock individuals as people have senior community in many market. very different opportunities ways: physical, emotional, and demands in these psychological etc, cannot turbulent times. This is be solved with logical particularly true for senior citizens. Vol 03 | Issue 03 | samarth | 7

COVER STORY blueprints, but by putting empathy over network (e.g., peers in the Samarth Milan, a logic, hearing over listening and caring over webinar for connecting elders virtually across changing. That is exactly what we at Samarth India). have striven to do during the last few years. Simply put, we have tried to be sensitive to 4.Recognize and act on “your” the emotional demands of our members. values 3. Rely on social networks Let me quote this from Wayne Brockbank: under pressure, some rocks become dust and Broad societal issues are often dealt with others become diamonds. Under pressure, in small communities where personal social some senior citizens have often discovered networks provide both tight ties of those new opportunities and yet others seem to who can support us and loose ties of those worry about the threats. The difference is we can learn from. In the last one year during often from being clear about one’s values. the pandemic, many of us must have endured Being sheltered, facing personal biases, the lockdown induced isolation, both physical and experiencing the economic and social and emotional. However many seniors have change can be a time to reflect and prioritize. also adopted the technology and stayed Answering (and re-re-re answering) the connected virtually with family and friends, question, “What do I want most?” becomes sharing personal time and virtual space. We a key to abundant living in a turbulent world had each been sheltered, but it was wonderful because it defines success, focuses energy, to have a social network like Samarth chapters and ensures personal peace in the midst of one can turn to for support and ideas. In external chaos. A Samarth member after three coming times also, seniors need to invest decades in US, having a successful career and in small social communities where they feel secure golden years, came back to India and supported (e.g., friends, colleagues). They instead of living with his family in a Metro city, also need to seek out linkages with those they chose to settle in a hill station with other elder can learn from who may not have been in their friends. Is it freedom? Is it a sacrifice? Or a blessing? It depends on his values, isn’t it? So let us all pause for a moment and ask once again, “What do I want most based on my deepest values”. 5. Focus on the process, not a solution When solutions are moving targets that keep changing common sense dictates that one should attend even more to the process. Should a business focus on growth or cost? Should a school offer in-person classes or only virtual? Should one go to the hospital for daily medical needs during pandemic or rely 8 | samarth | Vol 03 | Issue 03

COVER STORY on tele medicine? Should the way, no need to justify one’s choices, values, or goals. Life one allow domestic help or do one’s own chores? The is a lark at best, a tedium at worst. Such a philosophy agrees solution to such questions is sometimes less stable with Brendan Gill, who once quipped, “Not a shred of evidence than the process. All of us have life-long experiences exists in favor of the idea that life that will guide us to focus more on being transparent, Mindfulness is serious.” process oriented and clear On the other hand, despite our in our communication with friends and family members skills attempts to ignore these sorts particularly during and after (intentionality, of issues, there exists a “quiet the pandemic situation. conscious desperation” that drives all of us When the next generation breathing, and to think about the question, “Does understands and trusts the meditation) process, they will more likely life have meaning?” Deciding adapt to and appreciate the solution suggested by us. will help us that life does have meaning both 6. Be mindful pause, center, during and post pandemic, is not and savor the the end but the beginning of a Most importantly one must moment. quest. Life becomes a continual enjoy the journey, laugh, pilgrimage to find, affirm, and and discover. A great leader once advised: “Let us run reaffirm a philosophy of life. One may work through, retire, with patience the race that is set before us”. The question become religious, give up faith in God, join a cult (or leave however remains; are we mindful enough of the a cult), change allegiances, switch jobs, get married, get changing world around us so that we are patient with divorced, or make any number of changes in an attempt to ourselves and with others? Hopefully, mindfulness skills find meaning and purpose. No one can control what happens, (intentionality, conscious breathing, and meditation) but one can control the response to what happens. Let us not will help us pause, center, and savor the moment. react to the world emerging out of pandemic and chaos. Let us A mindless existence try to be granular, emotionally grounded, socially connected, requires nothing from anyone. There is no need remain true to our values, transparent and process-oriented, to check for bearings along and mindful as we try to make sense of this confusing world. What other advice would you give yourself and others? Vol 03 | Issue 03 | samarth | 9

Q& ACOVER STORY “ Our vision is with Samarth Founding Team “ that all senior citizens in “ India enjoy a high quality, independent lifestyle... Personal pain point over the trauma and guilt that accompanies ‘less than the best’ support for senior citizens in their families led a group of concerned “children” to launch Samarth with the aim to serve senior citizens and their sons, daughters and well-wishers. By Sangita Thakur Varma and Indrajit De What led to the idea best’ support for senior senior citizens and their sons, of Samarth? citizens in our own families. daughters and wellwishers. Senior care, an established, A. We believe that senior large and reasonably mature What is the vision business sector in developed and mission of citizens deserve a life that markets like the US, UK, Samarth? is comfortable, safe and Singapore etc. is in a very enjoyable – a universal wish nascent stage in India and A. Our vision is that all we have for our parents and represents a huge gap. elders. But a lack of adequate All of us co-founders are senior citizens in India enjoy care for them is a real issue in passionate about filling this a high-quality, independent India cutting across economic vacuum and therefore, we lifestyle without having to strata. Many of us have launched “samarth” (meaning move out of their community. personally witnessed the capable) that aims to serve Our mission, therefore, is trauma and guilt that rather straightforward: to accompanies ‘less than the bring peace of mind and 10 | samarth | Vol 03 | Issue 03

COVER STORY happiness to the elderly and join the Samarth community. touch and meets them their children who care about They can subscribe personally, our call-center or them. We realized that to do themselves or as we have through our mobile app. this, we have to act like the seen many times, their son or daughter or a trusted children can subcribe them How did you go friend of the elderly. to the program. Samarth about building community members are Samarth community? How does Samarth now present in more than 110 help elderly? cities in India. We also offer A. In our view, trust and A. We did a lot of research care plans for elderly which sensitivity are the two come with a 24X7 emergency most important aspects for with elderly Indians, their support at home or outside, serving the elderly. Our single children and family members and are currently available minded focus is on delivering living in India as well as across 40+ cities in India. on these two aspects. Our overseas. That and our own The members as well as their community building is largely experience taught us that our family can access Samarth through referrals and word number one priority ought to through an assigned care- of mouth. Our members are be building trust with the manager, who stays in regular the best, and most trusted, elderly. While in major cities means to reach other seniors. there are organizations If one of them believes in offering a range of services and experiences our work and products, the reason why and sees our passion, they elderly hesitate in accessing introduce other friends or them is the lack of trust. family to our community. Samarth offers support not We also have an outreach only for physical needs such program where we work as security, safety, medical with Senior citizen forums, services, home maintenance, RWAs, associations and out-of-home tasks but organizations also emotional needs such involved with senior citizens as companionship and to develop tailor-made entertainment, and even options for seniors. Even volunteering or part-time though our care services are engagement depending on limited to a few locations, what members want. our community program is available to senior citizens How does Samarth everywhere in the country. make its services Anyone above the age of 50 available ? years can become a member via our website www.samarth. A. We have a membership community and benefit. program for senior citizens to Vol 03 | Issue 03 | samarth | 11

COVER STORY What has been the and parks, at RWAs. These in India but continue to live response of people days we meet virtually alone in their houses. especially senior through zoom. However, citizens to this in almost all discussions, Our Care manager is the initiative? people share stories of how go to person for them for they were not treated well everything from doctors’ A. There is clearly a strongly or taken advantage of or appointment to buying stuff, the compromises they have organizing everything in their felt need not only among the made due to lack of reliable homes. There is a member senior citizens but also their support. Many people also couple in Gurgaon who used children who want to provide raise questions – about us to visit us atleast twice a them the best possible and and our people, how we fund week at our office to spend reliable support. In our most this, how we ensure quality, time with our team before recent samarth milan, the why we are doing this? But pandemic. Now we keep in get-togethers we organize once they are convinced, you touch through regular calls. for our members, we were can see the relief they feel, Another member works completely humbled by how that now they can perhaps for a couple of hours every confident and happy they felt live life on their own terms. It alternate day with us. having Samarth by their side. also puts a lot of pressure on us to deliver. We have many Almost every week we get All of us in the team, members aged between 70 requests from concerned meet many groups of senior and 85 who have children family members, who come citizens every week – Earlier it to know about Samarth, to used to be at condominiums, offer our care services in clubs, in mornings in gardens 12 | samarth | Vol 03 | Issue 03

COVER STORY this city or that wherever their parents stay. We have plans to cover the entire country but we want to do this without compromising on quality of our service. This means expanding our full services slowly. However, our community offering is available across the country. Having said that, many seniors can be very demanding and we have to constantly meet their exacting standards. But the love and affection we get, makes it all worth it. Vol 03 | Issue 03 | samarth | 13

COVER STORY QuickF 11.5Crore Number of elderly in India. This is roughly 8% of all population and makes India an ‘ageing’ country as per UN definition 12,000 Average increase in the number of elderly in India likely to happen everyday for the next 10 years 25% Of all new toys are purchased by the elderly in the US 36 million Number of older people who live without spouses. That is more than the population of Australia 14 | samarth | Vol 03 | Issue 03

Facts COVER STORY 0.032% Share of GDP the government spends on senior citizens in India 80% Percentage of all luxury travel in the US accounted for by the elderly 500% The increase in Indian population of oldest elderly (80 plus) between 2006 and 2050, as compared to overall population growth of 40% in the same period 1/3rd Proportion of the elder population over the age of 65 falls each year in the US. The risk of falls increases proportionately with age. At 80 years, over half of seniors fall annually. Falls account for 25% of all hospital admissions every year in the US.Samarth offers a safety audit or fall proofing of homes to its care members Vol 03 | Issue 03 | samarth | 15

INTERVIEW Identify your passion: Director of National Institute of Social Defence (NISD), Min. of Social Justice and Empowerment, Govt. of India Give me few men and women who are pure and selfless and I shall shake the world ” Swami Vivekananda Driven by this call to action from Swami Vivekananda, Dr. Veerendra Mishra has worked relentlessly to address the issue of human trafficking in any form across the country. He is a Police Officer (Madhya Pradesh Cadre) by training, a doctorate on ‘Changing Image of Police: An Empirical Study’ from Barkatullah University, Bhopal (2004) and recipient of the prestigious Hubert Humphrey Fellowship under Fulbright Scholarship. Dr. Mishra has served on two UN Missions in Bosnia and Kosovo and worked in East Timor. He was the Assis- tant Inspector General of Police (CID) and served as the Secretary, Central Adoption Resource Authority (CARA), Ministry of Women and Child Development, Government of India, before joining his present role as Director, NISD. Dr. Mishra is an author of standing and his book titled, Human Trafficking - The stakeholder’s perspective, was published by sage publication in 2015. In an exclusive interview with Samarth, Dr. Mishra provides his unique perspective on the state of eldercare in India, the related issues and role being played by NISD in addressing the same. ID: Sir, thank you so much for speaking to Samarth. As a country, what do you think are the key issues in taking care of our growing senior citizen demography? VM: India is a large country with an ever growing population of senior citizens. The popu- lation of senior citizens is expected to grow into 20% of the total population of India by 2050. This is going to be a challenging situation for the country to tackle especially if the issue is dealt in isolation. A major problem that our seniors face today is of mental health issues. This in turn leads to physical and psychological degeneration. Isolation, seclusion, lack of engagement are major factors accelerating the scale of problems being faced by seniors. 16 | samarth | Vol 03 | Issue 03

INTERVIEW However, in order to even comprehend the effect of these issues facing the elderly today, one has to understand that India has a demographic dividend. It is still a young country. By next year the average age of our country is going to be 29 years. And youth themselves today are facing lots of issues like drug abuse, drug dependency, unemployment etc. Unless we address the issues of our youth, we cannot address the issues of our seniors. The need is to create a strong bond between gen- erations, inculcate values of empathy and respect in the youth for their elders. Instead of going for grand changes overnight, the need is to bring in smaller changes like that in semantics. Addressing an elderly as, “बज़ु ग ������” instead of “ब ड़ु ा ” as we often hear people using, goes a long way in forging a bond of respect and helps in cementing the inter-generational relations. The greater question that I often ask myself is whether this demographic dividend, today’s youth, are prepared to take care of their senior citizens or are they even prepared to cope with the elder issues as they grow into their 60s. ID: What are the policy level changes being implemented in the country for enhancing the welfare of senior citizens? VM: Ministry of Social Justice and Women Empowerment has taken a very serious stand in addressing the issues of senior citizens and enhancing their welfare. So far many dedicated working groups have been created. The working groups have submitted their reports based on which, 7 empowered expert committees have been constituted to implement the recommendations. The Ministry has already allocated the required funds so that a lot many so far untouched areas can be worked on like nutrition for elders or elder care in rural areas etc. NISD is leading the initiatives in many of these areas and in next financial year, a lot many positive developments are expected. ID: In your opinion, how can the public awareness be developed/increased about the social responsibility of elder care at home? VM: Our parents have always told us that there should be atleast one senior citizen in all the houses to stabilize the family. However due to various socio-economic reasons, this bond has snapped today. People have gone into nuclear families, moved out and away from each other for career etc. However, is it somehow possible to bring back the old values and systems? Is it possible to connect each senior citizen in the country with atleast one family of young people? Irrespective of whether it is blood relation or adopted one, can Vol 03 | Issue 03 | samarth | 17

INTERVIEW each one of us take care of atleast one senior in our community? Can we take care of their needs, learn from their reservoir of experiences and build a more inclusive society? ID: What are some of the strategies that NISD has adopted to ensure greater participa- tion of stakeholders involved in elder care? VM: In all our interaction with stakeholders, we ask the question that as community members, are we doing our job? There is a dire need of engagement with senior citizens. Are we engaging with them enough? Are we talking to them enough? Elders love to share their experiences. Are we enabling them to do so? One of the goals of NISD is to bring back this spirit of elder care in the community. In order to do so, NISD engages with a broad base of stakeholders like government organizations, schools and colleges, private institutions, NGOs, individuals etc. One of the key initiatives we have taken at NISD is to set up the senior citizen helpline. This is a pan India helpline that will be able to provide counselling services to the elderly creating a referral system for their major problems, if not interventions. ID: Is there some idea or initiative that you are most passionate about? VM: One of the issues very close to my heart is the welfare of transgender senior citi- zens. They are in very bad state as of now. Their hands to mouth existence is totally dependent on the transgender youngsters, who themselves are struggling due to lot of social stigma attached with their being. NISD is exploring all the possible avenues to create a support system for them. ID: What would be your message to the samarth team, and to the samarth community of seniors across the country? VM: Every person, every senior citizen has some strengths. What they should do is try and identify their strengths. Realize your passion, and find your strength. Once the elder finds his/her passion, and find the space to engage with their passion within the community, they will be happy. However, there is a limit to which any government can support its citizens and every elder should be willing to self-support in order to identify their passion. ID: Thank you so much sir. Your last 7 years’ journey in the social sector has been truly wholistic and insightful. You have worked with toddlers, youth as well as elders with equal passion and are mak- ing a great impact in the way our com- munity interacts with them today and in the time to come. 18 | samarth | Vol 03 | Issue 03

HEALTH HEALTH MIND THAT FALL! Avoid hip fractures by just following these tips. By Asheesh Gupta Fracturing the hip is something MIND THAT FALL! that most elderly and their family members dread. Rightly so, given used. He suggests using FDA approved implants the high incidence among the elderly if the patient can afford them. and potentially debilitating impact on both the A majority of these fractures occur from a fall. elderly and their family members. International For seniors, hip fractures can be difficult to Osteoporosis Foundation reports that over the recover from, reduce independence, and can past 30 years, fractures have gone up threefold cause serious complications. They are more in Asia, with India and China topping the charts. common in older women, since menopause Somewhat older data puts the number of hip reduces estrogen, which accelerates bone fractures to over 4.4 lakh people every year in loss and leads to osteoporosis. Osteoporosis, India. a treatable condition in which bones are For people above 60, this injury can completely weakened, is a common risk factor for hip redefine life after the fracture. Statistically, one fractures. Advanced surgery is also sometimes in three people who lived independently before not possible with elderly given their overall a hip fracture, spend six months or more in fragile condition. continuous nursing care afterward. Forty per cent of hip fracture sufferers are unable to walk independently a year later, and 60 per cent can no longer take care of everyday necessities, like getting dressed. Older adults can also have life-threatening complications during or after surgery to treat a hip fracture, such as blood clots, infections and heart arrhythmias. Dr. Rajesh Verma, senior orthopaedic surgeon and traumatologist at Artemis Hospital, Gurgaon, who also offers expert advice to Samarth Community members, says that situation and treatments especially replacement techniques have improved considerably over last few years and a patient can walk, albeit restrictively, within a few days of hip fracture. The cost of such treatments can vary significantly depending on the hospital and especially the type of implants Vol 03 | Issue 03 | samarth | 19

HEALTH STEPS TO AVOID HIP FRACTURE There are several recommendations for older adults to prevent a hip fracture: 1. Ensure the home environment Take the right supplements under your doctor’s is safe: With bars in the bathroom, handrails supervision along with diet that is rich in calcium and Vitamin D but do not stop there. Get plenty along stairs, rooms free of of potassium-rich fruits and vegetables daily clutter and cords, and bright as this mineral has a positive effect on calcium lighting, you can ensure your metabolism. Don’t skimp on protein, it helps safety. Remove throw rugs, by maintaining muscle mass (important for consider lowering the height strength). of the bed and chairs. Keep the home free of clutter and unused furniture. 4. Check your eyes and ensure Good lighting is necessary, recognize that as best vision: Get annual vision tests eyes age they need more light. Make sure every room and passageway is well-lit. At Samarth, we and ensure vision is being conduct a 98-point home safety audit for our corrected appropriately. members to help reduce the chances of fall and If you have diabetes or an injury at home. eye disease, then you might need eye checkup more 2. Keep muscles strong: Exercises that often. These are simple life hacks to ensure quality retirement. Your final maintain muscle strength, days should be stress free and fulfilling. But endurance and balance can to achieve that one must plan with prudence lower your risk for the slips, and foresight. Easier said than done but not trips and tumbles that break impossible to get done! bones. In one study, women who had not exercised in a 5. Evaluate effect of medicines: year were at higher risk for hip fracture, even if they did not have osteoporosis. A regular Evaluate medications to exercise routine can cut your risk of a fall by 20 ensure they don’t cause per cent to 30 per cent. Focus on strength and dizziness or drowsiness. balance exercises. Physiotherapists can suggest Avoid moving around too the right regimen for you. much when such dizziness or drowsiness is expected from 3. Eat right: Doctors recommend 1,000 mg medicines. In any case, if you feel drowsy, dizzy, weak or of calcium daily for women off-balance when walking, ask your doctor for a before age 50 and men medication check. Some prescription drugs can before age 70, then 1,200 cause these fall-inducing side effects. mg for women over age 50 and men over age 70. You 6. Stand up slowly: Getting up too also need vitamin D to help absorb calcium. quickly can cause your blood pressure to drop 20 | samarth | Vol 03 | Issue 03

and make you feel wobbly. 7. Use a walking stick or walker: If you don’t feel steady when you walk, ask your doctor or occupational therapist whether these aids might help. 8. Consider using normally advise an X-ray to determine the hip protectors: There severity of injuries. Sometimes the surgeon will ask for a computerized tomography (CT) are various kinds and should be considered scan, magnetic resonance imaging (MRI), or in high risk cases. The most common of them bone scan for further evaluation. Most often, is in the form of reinforced underpants with hip fractures require surgery. The patient may removable protectors. Their efficacy varies require a partial hip replacement, total hip based on the nature of fall but they do provide replacement, or “hip pinning,” in which metal protection in case of direct impact. screws, rods or plates are used to hold the bone together as it heals. Surgery is typically What to do in case of suspected completed as soon as possible, often within hip fracture? 24 hours, to reduce complications and speed recovery. If a person falls, especially an older adult, they After surgery, patients are encouraged to should first determine where they feel pain. A move as soon as they can to avoid blood clots lack of severe pain normally means there is no and other complications. Some patients will significant injury. However, if there is a significant need to recover in a rehabilitation centre as amount of pain or if they can’t place weight on they regain their strength and ability to move the leg, that person should stay imobile and around through physical and occupational paramedical help should be called. Once the therapy. Full recovery can take up to a year. patient is evaluated, an orthopaedic surgeon will Vol 03 | Issue 03 | samarth | 21

HEALTH Dental Care for Older Adults Preventive methods can help in maintaining dental health among elders. Here are some simple solutions for great oral care. By Prof (Dr.) Sharad Gupta & Dr. Vishakha Gupta Aging is a normal Advancements in medical that teeth and gums can be Physiological sciences and technology has phenomenon, led to emergence of newer made to last till the very end. unstoppable and and better modalitiesof health biologically driven. care including prevention and Advancing age puts many Advancements in medical treatment leading to increase sciences and technology in life span of the individuals. seniors at risk for a number of has led to emergence of The elderly population starts newer and better modalities from 60 years onwards and oral health problems, such as: of health care including can be looked upon as those prevention and treatment 60-74 (young old; healthy and • Teeth become dark and leading to increase in lifespan active), 75-84 (mid old; active of the individuals. Aging but with systemic issues), > 85 stained and show signs of is a normal Physiological (oldest old; less active more phenomenon, unstoppable ill). At every stage oral care wear. Increased wear can and biologically driven. needs to be addressed so also lead to sensitivity, cracking and cavity formation. • Oral mucosa becomes thin and is more prone to cuts due to denture wearing or aggressive tooth brushing. There may be burning 22 | samarth | Vol 03 | Issue 03

HEALTH sensation with poor implant are a big boon for tolerance to spicy and hot food. elderly and can assist • Salivary flow decreases and special tooth crèmes and could be due to can prevent cavities can be medicines for medical problem or otherwise used after consulting due to salivary glands shrinkage. Decreased dentist. salivation can lead to root caries and untimely tooth • Remove dentures after loss if not prevented. every meal, wash and • Gums and tooth bone wear. When sleeping recedes and if oral prohylaxsis is not remove dentures. At night maintained, greater damage can occur with used for the same. wash dentures with denture eventual loss or poor brush and plain soap and bone for fabrication of • Plaque and Tartar control dentures or Implant Bridge compromising quality of should be achieved both by keep in a closed dry life. However, some preventive professional cleaning once in container. Soaking methods can help in maintaining dental health every 6 month and through overnight in water among elders. Some of the following methods can be home care regime. promotes bacterial and • Electrical tooth brushes fungal growth. can be of great assistance • Use warm salt water for in elderly. Effective use of rinsing/ gargle at least fluoride and Chlorhexidine once a day. based mouth wash can • Keep your dentist number prevent cavity and gum handy for any emergency. recession. • Preventive check-ups and fillings can reduce tooth About the Authors damage and tooth loss. Prof (Dr.) Sharad Gupta is a Dental specialist practicing • Modern solution like Dental with his wife Dr. Vishakha Gupta at their state of art centres Identity+, based in Gurgaon and New Delhi. The couple is dedicated to help elderly retain their smile by conducting awareness talks, consultation camps and affordable dental care for the elderly. Vol 03 | Issue 03 | samarth | 23

HEALTH WHAT’S IN A A lot! Each bite must be nutrient-dense for BITE? our elderly especially. h staff By Samarth staff ‘Chew your food’ is probably an oft- repeated statement by moms the world over. Science shows that this age-old wisdom has a lot of merits - from regulating digestion to preventing bloating, gas and even overeating, chewing has a host of benefits for us. Have you ever asked of chewing time, digestion This helps food move easily your children and in the stomach and small through the esophagus. Saliva grandchildren to intestine, and so much more. also contains enzymes that chew their food more slowly? By the time you get to the begin the breakdown process Do you often feel that sitting end, we are sure you will be of the carbohydrates. in front of a television screen more mindful of your eating while eating makes you patterns. Try out this simple exercise- feel hungry sooner? There eat some plain rice and chew is reason to believe that The Importance Of it at least twenty-five times. chewing adequately helps Chewing After a while, do you notice not just to digest food more a sweet taste in your mouth? quickly but also contributes to Chewing is the process of This is because the enzymes our feeling of satiety- in other using teeth to break food in saliva help break down the words when we eat more down into manageable, rice into simple sugars. mindfully, we feel less hungry. digestible pieces. Wild animals have sharp teeth that “Eating slowly contributes This is why we have help them break down their to a lower risk of obesity, dedicated an entire article to prey and also chew quickly. probably because it could the process of digestion. We Human beings, over years of aid appetite control. Chewing will discuss aspects such as evolution, have developed thoroughly is an effective chewing food with artificial teeth that aid in cutting, strategy to reduce eating rate” dentures, the right amount chewing and grinding food. - Zhu Y, Hollis JH, Journal, The Academy of Nutrition, 24 | samarth | Vol 03 | Issue 03

HEALTH 2013. morsel, wisdom that comes result, they make a hard bite In other words, digestion from expert advice as early difficult. Over time, due to as the 1800s. Saliva contains mechanical damage, you may begins well before food amylase and lingual lipase, have to resort to softer foods reaches the stomach. It enzymes that break down which your natural teeth begins in the mouth. carbohydrates and fats could have helped chew. respectively. Hence, never opt for artificial How Many Times dentures except as a last Should You Chew Ayurveda says that resort. Food? chewing food adequately sends signals to the brain Sometimes, painful as it While there is no fixed rule, about the nutritional profile may be, the best solution at a bare minimum, we of the food you are eating. to deal with tooth decay is must chew each portion in The brain can process these a root canal procedure. A our mouth at least twenty signals and release digestive dentist is the best person times. Some sources say that juices in the right proportion. to evaluate whether you thirty-two times is ideal per In any case, most of us need replacement dentures probably chew no more than or if a simple root canal will fifteen times. Hence, it is a suffice. A dental x-ray may be good idea to be mindful and ordered to use as a baseline chew a bit more than you for these procedures. usually do. Digestion: How Does Chewing Issues As It Happen? One Ages The digestive process starts As we age, several factors in the mouth when food is can contribute to a weak bite. chewed and mixed with saliva Some of them are produced by the salivary glands. It moistens the food • Tooth decay to enable smooth movement • Missing or falling teeth through the esophagus which is a tube that connects the • L oss of strength in the jaws mouth and stomach. Until the • Ill-fitting dentures food reaches the oesophagus, the process of digestion • Parkinson’s disease which stays voluntary. After this, it becomes involuntary and is makes muscle coordination controlled by the brain and difficult. digestive system. As early as a decade ago, some seniors would opt for When the food reaches dentures to replace teeth that the stomach, the upper part were decaying, but otherwise of it relaxes to receive large healthy and in their place. However, artificial dentures are often not the best Vol 03 | Issue 03 | samarth | 25

HEALTH amounts of food while the Five Reasons To gas. lower portion stores the food Start Chewing Your and mixes it with necessary Food Today Still not convinced? Here’s digestive juices. It primarily produces stomach acids and Here are five quick and easy what happens when we do some enzymes that digest to remember reasons why protein. The contents are then you must chew your food: not chew food well enough: emptied into the small 1. Broken-down food releases intestine where some more 1. We don’t enjoy food as we juices from the pancreas, more nutrients into the liver, and intestine are mixed body. aren’t eating mindfully. with the food to aid further 2. Since chewing well takes digestion. time, we don’t eat in a 2. Not chewing well and hurry and instead eat only Bile, produced by the liver, until we feel full. swallowing quickly leads is essential to break down 3. The longer we chew, the or dissolve fat to enable more time saliva has to to GERD, a condition in digestion of fat molecules. break down complex Some more juices from the carbohydrates. which stomach contents small intestine combine with 4. Do you know what the this semi-digested material best workout for your rise back up into the to complete the process gums, teeth and facial of digestion. Glucose, the muscles in general is? oesophagus and injure the primary energy molecule Chewing! obtained from food, is 5. Chewing reduces the delicate lining. absorbed into the blood involvement of gut flora in which carries it to various digestion, which in turn 3. Improperly chewed food parts of the body. leads to less production of causes improper digestion, The undigested component of food is pushed into the bloating and gas. large intestine which absorbs any remaining water and 4. Lysozyme in saliva helps converts it into stool which is stored in the rectum until destroy common excreted. pathogens. For it to It is easy to see why digestion is a complex act, adequate time is process- it begins in the mouth where voluntary necessary, which chewing digestion happens. Hence, chewing is the very basis of a well provides. healthy gut. 5. When enough saliva does not move around the mouth, food particles get stuck in the teeth and 26 | samarth | Vol 03 | Issue 03

HEALTH cause decay. Chewing causes more saliva to be released. Here’s a simple exercise to get you started on the habit From the time we eat to the time nutrients are of chewing. absorbed into the body, there is a timegap of at least 1. When you have your meal today, measure the three hours. Some doctors recommend that not chewing amount of time it takes you to finish. Don’t begin food well enough can cause a lockage in the windpipe chewing more than you usually do just yet. which in turn can cause us to choke. Hence, it is important 2. In the next meal, aim to increase the amount of to chew food well, to enjoy every meal we consume and eating time by two minutes. In each meal, increase to advocate chewing the time in two-minute increments. food well, especially 3. Make a promise not to watch with our fellow television or look at a screen silvers. while eating. This helps focus on the meal and chew properly. 4. If you consume carbohydrates like rice and chapatti, chew until you notice a characteristic sweet taste in your mouth. 5. Go in for regular dental checkups to look for tooth decay and prevent problems before they arise. 6. If you use dentures, be sure to clean them properly and ask for a replacement as soon as they are worn out you can tell by your ability to enjoy foods even in their harder form. Vol 03 | Issue 03 | samarth | 27

SAMARTH HEALTH INSURANCE All You Need To Know About Health Insurance The general feeling that health insurance is a waste of resources has prevented elderly from opting for this essential cover. Here is a primer on this safety valve. By Subha Chandrasekaran With increasing years comes the diseases, such as cancer, stroke, etc. A good need for increased medical policy for senior citizens should ideally go care and attention. Yet, health beyond just hospitalisation and hassle free insurance is an oft ignored settlement of claims is important. Keep in product, especially in our country. As we grow mind that health insurance can literally be a older, the need for health insurance becomes life-saver when a huge medical emergency more prominent, what with frequent checkups strikes. Smaller, regular medical needs can and visits to the doctor. However, less than 10 always be planned for and attended to. In an per cent of the country’s population has life emergency, access to funds and hasslefree insurance, and health and medical insurance are processes become key. generally taken when an employer is offering them. Having health insurance is very important because unexpected health emergencies and surgeries can dry up your financial resources very quickly. Health insurance schemes are definitely available for senior citizens too, with various special features, such as cashless hospitalisation, critical illness coverage, specific coverage for 28 | samarth | Vol 03 | Issue 03

HEALTH How do you choose Check the details before the insurance company a good health you sign up. will pay. You can then insurance plan? allocate the rest of the Some Benefits To amount to emergencies. 1. Never let the premium Look For If you agree to co-pay some of the amount amount act as a deterrent. As per norms set by Insurance and expenses, you may As you age, your premium Regulatory and Development be able to get a lower amount increases, but this Authority (IRDA), health premium. is a necessary expense that insurance is to be provided Most policies offer can save you from spending to all people who apply, until complementary medical in six figures when you they are 65 years old, and checkups every year at need medical aid. for as long as they wish to be network hospitals and enrolled in such a plan. There diagnostic centres. 2. It is not true that people are some additional benefits We spoke to Mr. Sharad that some health insurance Gupta, an expert who has over a certain age cannot plans offer: been working in the field of get medical insurance. The insurance for many years, only thing — as you age, the A list of pre-defined about how seniors should think number of tests you need critical illnesses can be of insurance and he had some to undergo can increase covered for an extra very valuable suggestions. He significantly. This too is a premium. says, “There are four things one-time effort, well worth For pre-existing illnesses, a senior citizen should keep the outcome. there is usually a waiting in mind. One, get insured as period of up to 4 years early as possible. Once you 3. Check for the network of after which these illnesses get a disease, the coverage for are covered in the plan. that pre-existing condition will hospitals covered. The Some policies offer a become expensive and in some more in number they are, lower waiting period of cases may not be available at and the more convenient 1–2 years. all. Two, make sure you declare they are for you to visit, the For surgeries, such as your medical condition as better the plan for you. cataract, you can choose to set a limit on how much 4. It is estimated that health- care costs go up each year by about 15 per cent. 5. Consider this inflation before deciding on the sum assured. A larger sum assured will not always increase the premium exponentially. 6. Whenever possible, opt for a lifelong plan that covers you for the rest of your life. Senior citizen plans are designed to cover pre- existing illnesses as well. Vol 03 | Issue 03 | samarth | 29

HEALTH explicitly as possible at the of the policy period. If your Pre-existing illness: This deductible amount is `5,000 time of buying a policy. Any and the medical bill you incur is an illness or condition that in this period is `10,000, you you already have at the time attempt or mistake to hide pay only `5,000 and the of taking the policy. Premium insurance company pays the amount is decided based on a pre-existing condition will rest. the severity of this illness. give the insurance company Exclusions: This is a list of Premium: It is the amount reason to deny the claim. diseases, conditions, surgeries you pay at regular intervals and procedures that the policy to the insurance company. Three, consider co-pay and doesn’t cover. Advanced The total premium you pay is eye surgery for cataract and almost always less than the deductible options which total amount you are covered cosmetic procedures are some for. However, most health tend to reduce the insurer’s examples. insurance plans do not offer maturity benefits. risk and, thus, the premium, Lifelong plans: Most Maturity: The period of time but will give you coverage insurance plans have an entry limit of 75 years. However, you after which the insurance plan for any big expenses — which can choose a plan that has ceases to cover you. Do an entry limit but also covers remember that plans can also is when most people really you for as long as you live. lapse upon non-payment of Premiums are usually higher premiums. need a helping hand. Four, for such policies. Be Aware of the Fine consider critical illness covers Pre-defined illness: This Print which are available for most is a disease or disability that is In a country as vast as India, often critical and included in a insurance is often a matter of major conditions. If you do not policy. signing on a few papers. No one cares to explain the minute have that condition already, details of a policy unless we ask them to. Also, bogus insurance then you may be eligible companies are aplenty, and they make money of the more for the cover. Since critical gullible people by offering too- good-to-believe offers. With illness covers are usually paid apathy and lack of awareness, on the one hand, and poorly only one time by the insurer, trained agents on he other, it is very easy to fall for a health immediately when that illness insurance trap. Here are a few things to look out for: is detected, the premium tends 1. Sometimes, the policy itself not to be too high.” There is some insurance jargon that may seem confusing, so it is good to be aware of what they mean. Co-pay: When you agree to co-pay, you and your insurance provider will split the medical bills at an agreed ratio. So, if you agree on a 70:30 ratio, when you need medical aid, and the bill comes to 1 lakh, you will pay 30,000 and the insurance company will pay 70,000. Deductible: This is usually paid only at the beginning 30 | samarth | Vol 03 | Issue 03

HEALTH could be fake. What this policy statements. policy you need to consider means is that the person 3. If the person offering the your options. offering it pretends to be 6. Do remember that no from a real company and policy is incessant in their insurance company is signs you up for a monthly quest, and repeatedly exempt from IRDA norms, or annual payment. You calls you for personal and if someone claims that will be paying insurance information, think twice! they are able to offer special till the time you want to As a customer, you can benefits as they don’t have claim it, only to realise that instinctively make out the to register with IRDA, it is it is a scam. How can you difference between a really a scam. All in all, be sure to avoid this? Always choose good salesperson and read the fine print of your a policy from a well-known someone desperate to just policy very carefully. If you company. It is not a bad push their goods. Anyone have questions. Do not idea to visit their office at who is this desperate to sell hesitate to ask your agent least once. If you haven’t a policy may actually be until you are satisfied. heard the name of the doing something outside company before, do an the purview of the law. Travel Health internet search to check 4. Health insurance deals often Insurance what others have to say don’t expire at very short about the policy. notice. If an agent claims This is beneficial for people of 2. Always make premium that your deal is about to all age groups. If a sudden payments only in the name expire very soon, then there illness strikes when you of the insurance company is something fishy. are in another country, the and never in the name of 5. If your choice of insurer is medical costs may often be any individual or agent. Ask not paying your medical bills prohibitively expensive. In for payment receipts or promptly stating reasons such cases, a travel health that are not included in the insurance covers you and pays Vol 03 | Issue 03 | samarth | 31

HEALTH your medical bills. commonly seen in case of to accommodate existing Most travel agents and portals organisations that cover illnesses as well. offer travel insurance when all their employees and For these benefits and more, you purchase tickets. Be sure sometimes, their dependent group policies are often to read the fine print and family members as well. preferred. Would you be compare your cover amount 1. Since the insuring company interested in getting a group with average medical expenses policy for yourself and your in the destination country. gets members in bulk, they spouse? You can use websites, such as are more willing to offer policybazaar.com, to compare discounts and incentives how much you are paying that are absent in individual versus how much cover you policies, such as a discount get. Remember, most travel on the boarding fee. health policies only cover the 2. Group plans enable you to person insured. So, you will make the transaction at need a separate policy for each hospitals cashless and traveller. In some cases, travel seamless, as they usually agents may be able to provide come from various reputed a group policy for large groups agencies. of people. 3. Some policies can also It’s a simple procedure that cover pre- and post- can give you immense peace hospitalisation fees, which of mind as you set off to see is a huge advantage. new places. 4. Even for day surgeries, you won’t have to look beyond The Benefits Of A such a policy. Group Policy 5. Such policies may offer you a better cover in case of Group health insurance is terminal illnesses, such as often offered by organisations cancer. that have a certain number of 6. If you pay extra premium, a members. This is most group policy may be able 32 | samarth | Vol 03 | Issue 03

Some Health Insurance Plans To Consider Here are some of the most popular health insurance plans for senior citizens according to policybazaar.com. Insurer Age Sum Pre & Post Pre-existing Medical Policy Name Assured Hospitalisation Diseases Check-up Expenses Bajaj Allianz- 46–70 (`) Covered from After 46 years of age, Silver Health yrs Up to 3% of the 2nd year required as listed Plans for 50,000– admissible of the policy below: Complete Senior 5 lakh hospital medical report, ECG, Citizens expenses Fasting BSL, Urine R, incurred Liquid profile, HbA1c, SGPT, CBC, SGOT, CBC, Sr. Creatinine ICICI 46 and Up to 10 30 days & Covered from Medical tests Lombard- above lakh 60 days, the 3rd year of required for anyone Complete respectively the policy (upto above 46 years of Health 4 yrs for sum age at particular Insurance assured 4 lakh; diagnostic centres subject to non- stop renewal) Star Health- 60–75 1,00,000– Only post-hospital Covered from Non pre-acceptance Senior Citizen yrs 10,00,000 expenses maxi- medical test required Red Carpet the 2nd year Health mum up to `5,000 of the policy Insurance excluding nursing Policy charges, diagnostic charges, medicine & consultation fee National 60–80 yrs Mediclaim 30 days and Covered after Not required if Insurance - renewable 1,00,000; 60 days post, 1 claim-free insured was covered VARISHTHA up to 90 Critical respectively year while by a health Mediclaim for yrs of illness - policy remains insurance for last 3 Senior Citizens age) 2,00,000 in force yrs; required for test New India- 60–80 yrs 1,00,000– 30 days pre- Covered after Required Source: Policybazaar Senior Citizens (renewable 1,50,000 hospitalisation 18 months of Mediclaim up to 90 (max up to 5% of policy Policy yrs of age) hospital bill) and inception 60 days post- hospitalisation (max up to 10% of hospital bill) Vol 03 | Issue 03 | samarth | 33

Health Advisory Precautions to take if pollution levels rise through AQI (Air Quality Index) meter ELDERLY, PEOPLE WITH CHRONIC CHILDREN AND LUNG DISEASE, PREGNANT WOMEN HEART DISEASE 0-50 Normal Normal activities activities Good 51-100 Normal activities Normal activities Moderate Minimise prolonged Avoid prolonged or strenuous outdoor 101-200 or strenuous outdoor Unhealthy physical exertion physical exertion 201-300 Minimise Avoid outdoor activity outdoor activity Very Unhealthy >300 Avoid Avoid outdoor activity outdoor activity Hazardous To check AQI rating to measure pollution levels - 34Do| swanmloaratdh |PVluoml 0e3 a| pIspsufeo0r3regular air updates on the phone or check www.air.plumelabs.com/en/live/new-delhi or www.aqicn.org/city/delhi/

OUTDOORS INDOORS regularly Refrain from morning walks and restrict X outdoor activities Use face masks when Air purifying plants outdoor Purify your car air Take steam daily IMPROVE YOUR DIET Ventilate your Jaggery to detoxify kitchen, bathroom Diet rich in vitamin C, Ventilate your omega fatty acids home Herbal tea and drink Preventive Plan Guide to protect yourself from pollution Vol 03 | Issue 03 | samarth | 35

STUDY SURVEY/ INSIGHTS Developing service quality standards for senior living facilities in India! By Samarth staff Inspite of an already led by co-founders Asheesh USA, ISB Hyderabad and large elderly population Gupta (Principal Investigator) Vedica Women Scholars which is growing at a and Anuradha Das Mathur Program contributing as fast pace, eldercare in and the work was mentored part of the project team. The India with regards to health by AshaDas, IAS, (Retired) developed standards were and well-being, housing Secretary (MSJE) Government ratified and pressure tested for elderly etc. is largely of India with technical advice in multiple expert forums neglected. Until recently, from Mr. Venkatesh Srinivasan with representations from a facility dedicated to the (Assistant Representative, Quality Council of India, NABH elderly was a rarity and UNFPA), Dr. Sanjay Kumar (National Accreditation Board even today, the number is (National Programme Officer, for Hospitals & Health Care abysmally low. With this UNFPA) and Ms. Sugandhi Providers), Professors from reality in mind, Tata Trusts Baliga (Head, Geriatric Delhi University, Owners and collaborated with Samarth Programme, Tata Trusts). The Managers of old age homes to develop a draft of service project, which took more and corporate player etc. This quality standards in senior than 4 months with research study followed a fact based living facilities in India. The scholars from Yale University approach to develop a robust Samarth project team was & McCombs University, estimate of demand for senior Example of developed Star Rating system Key Result Performance Minimum Standards 2 Star 3 Star 4 Star / 1 Star Area Area Same as 3 Star + A. Has on premise clinic with Physical Health services A. General practitioner is avail- Same as 1 Star + Same as 2 resident doctor, nurse and A. Ensures Star + emergency facilities to take needs able on call in case of emer- monthly vis- A. Geri- care of elder healthcare needs. its of medical atricians, psy- B. Maintains a well-equipped gency practitioner for chiatrists and rehabilitation center o ering consultations other experts physiotherapy, massages etc B. Has an identi ed hospital for B. Provides are available on the facility. an attendant on call C. Provides stand-by ambu- meeting emergency and other (atleast one for B. Has a lance for quick emergency every 10 resi- resident reg- access to full-service hospital hospital care needs of the resi- dents) istered nurse D. O ers regular consultations C. Has tie up available 24x7 with counselors, geriatricians dents with patho- C. Has tie-up and other medical specialist at logical lab for with a rehabil- the facility C. Emergency ambulance is sample collec- itation center E. Maintains personal medical tion and other o ering phys- care plan for each resident available on call 24X7 relevant health iotherapy, check ups massages D. Maintains record of age, allergies, pre-existing, medical conditions, weight, and blood group at time of admission and key health related events of resi- dents thereafter. 36 | samarth | Vol E0.3Ha| sIsasduoecu0m3ented protocol for informing the family member in case of health emergencies

SURVEY/ INSIGHTS living facilities in India to security, dignity and respect senior living facilities. For each help understand the nature as well as management of of the metrics, the mandatory and scale of challenge. With minimum standards were an extensive sample set of defined. In addition, 480+ old age homes and 60+ progressive voluntary senior living developments in standards of excellence based 84 cities, towns and districts on rating system have been cutting across geographies, recommended for each. The size, cost, facilities offered, project emphasized the need ownership and management, for training and capacity the study projected an building of care givers and estimate of around 1,150 recommended the setting facilities and the capacity to up of “Model Senior Living house around 97,000 elderly Facility” to ensure the delivery residents and pointed towards of minimum standards all a crying need to enhance across the country. the capacity almost eight to ten-fold over the next 1 INFRASTRUCTURE Recreational facilities decade. Global benchmarks Sleeping space Premises were analyzed to gather Other spaces and Toilet and bathing insights and understand facilities facilities the standards/ systems implemented in other 2 PHYSICAL NEEDS Health Services countries, based on scale, Food economic development and stage of evolution of the 3 SAFETY AND SECURITY Hygiene and infection system. Seven countries Fall and accident control UK, USA, China, Singapore, prevention aids Medication control Hongkong, Mexico and Fire protection and Protection Malaysia – were chosen emergency evacuation against abuse for their work in evolving elder care model or for 4 DIGNITY AND RESPECT Psychological support demographic similarity to In-home activities Caring and India. and outings supportive sta Enabling family and Privacy and dignity 5 key result areas and 28 community connect Personalised care performance metrics were identified which offer a set of 5 MANAGEMENT OF THE CENTER comprehensive, measurable Sta ng Quality Assurance and practical standards includ- ing infrastructure, physical Advisory board Complaint redressal needs fulfillment, safety and Financial condition Residents’ participation and occupancy rate indecision makin g Essential utilities Transparent documention Competence of and information the manager Vol a0v1a3i|laIbssiluitey 03 | samarth | 37 Record keeping

SURVEY/ INSIGHTS SAMARTH SURVEY 29% 40% Awareness about Awareness about senior minimum service living facilities in India Quality standards in senior living Facilities 24% Age of 18% 82% Respondents (Total 487) 76% 14% 7% 3% 7% >76 years 61-65 years Aware Not Aware Aware Not Aware 71-75 years 56-60 years 66-70 years <55 years Recent survey of it was no surprise that nearly Vol 02 | Issue 05 | samarth | 69 the Senior Housing 74% respondents stated to facilities and Senior have considered moving to minimum service quality to Housing senior living facilities. A look be expected in the facilities, Developments was conducted at the survey data below that is the challenge. Only by Samarth to understand clearly highlights that more 18% respondents stated that the prevalent perception than any other reason the they are aware of some sort of of elders about living in old absence of a willing care taker minimum standards that the age homes and elder care in in family forces the elders to old age homes in India need those facilities. We got a huge consider living in senior living to follow. Clearly the stage response from our community facilities. Given a choice they was to develop minimum of elders with nearly 450+ would have preferred to age and rating based service responses. In today’s time with in place. However since 76% quality standards in senior families becoming smaller respondents expressed their living facilities/ developments and nuclear, and both the awareness about old age underscoring the importance partners working hard to homes that can be referred of the Tata Trust project that make a living, many seniors to friends and family, it is we completed. are considering being on their not the lack of awareness own, living life independently about the facility but a lack Another unique insight with dignity and pride. Hence of awareness about the is the fact that maximum number of respondents (69%) are in the age group of 61 – 70 years; elders who may have 38 | samarth | Vol 03 | Issue 03

SURVEY/ INSIGHTS just retired, mostly are in Have conGseidoegrreadphmicoavlindgisttoribouldtioagneoffarceilsiptyo?ndents the working physical mental North condition and belong to 34% one of the richest demo- graphic dividend. In spite of East 89% being male respondents, 15% the data is definitive enough to warrant a thorough West estimation of demand supply 19% gap in the present senior living facility market and underscore the need for quality facilities in time to come. Central 9% No 13% Yes 88% No 29% South Yes 71% 23% Grand No 27% Total Yes 73% Most Important reason to move to senior living facilities Others reasons 10% Wish to be among like-minded peopl e 25% Returning from abroad after long time 7% Desire to stay away from childern/family 5% Unable to maintain home independen tly 29% Feeling of loneliness 26% No one available/willing to take care 23% 37% Medical condition of senior citizen Vol 013| Issue 03 | samarth | 39

SURVEY/ INSIGHTS Happiness Index What is it, how is it measured, why it is important and key insights into the happiness quotient of Samarth members By Samarth staff fourth king, Happiness index cultural diversity resilience, or Gross National Happiness good governance, community We strive for (GNH) refers to the nation’s vitality, ecological diversity the benefit policy of balancing modernity resilience, good governance, of economic with preservation of traditions, community vitality, ecological growth and mostly by resisting laissez- diversity and resilience, and modernization while ensuring faire development. Its four living standards. The nine that in our drive to acquire pillars are good governance, domains have around 33 greater status and wealth sustainable development, clustered indicators with we do not forget to nurture cultural preservation and 124 variables between them that makes us happy to be environmental conservation. (illustrated in the following Bhutanese” The pillars are further divided table). Bhutan may be a small - Extract from His Majesty of into nine action points: mountain country but as far as Bhutan’s speech during the psychological well-being, keeping its population happy, Madhavrao Scindia Memorial health, education, time use, the country is a torch bearer. Lecture in 2009 Coined in 1972 by Bhutan’s 40 | samarth | Vol 03 | Issue 03

SURVEY/ INSIGHTS Finland ranked first among 156 countries in the latest World Happiness Report, which asked people to rate their happiness levels on the above-mentione criteria. All these countries even though geographically apart share a common thread. A deeper prodding into the survey data brought to the surface a few key factors responsible for these countries being so happy: When it comes to happiness, Scandinavian countries like Freedom: “Freedom Denmark, Finland, etc., know what they’re talking about. Recently, of the population is tied to the freedom of the Vol 013| Issue 03 | samarth | 41

SURVEY/ INSIGHTS individual.” So which ever state ensures that its subjects are free to experience freedom by all means, ends up on top of the happiness index. Equality under the law: In order to contain corruption and build community trust, the people must start respecting each other at a humane level. This often gets reflected in their trusting the system or administration. However, the administration must also reciprocate by treating its subjects as equal. Gender equality: Only a gender blind 42 | samarth | Vol 03 | Issue 03

SURVEY/ INSIGHTS society can progress to the treatment of young and old, stock of the situation and top of any development the presence of a society are actively addressing and the Danes are leading that respects religions and the problem. The Samarth by example. belief systems in all forms, survey is one such initiative etc. In the survey, India to understand the pulse of Relaxed atmosphere ranked 133rd out of total the community and take to work in: In order to 156 participants. proactive steps much in advance. optimize productivity, the The country today stands administration must ensure at a crossroads with many In our endeavor to unbiased and relaxed important decisions to understand the perception of working environment. make – which path will it happiness within the Samarth walk on, what values will the community, we conducted Welfare society: In any next generation embrace, our version of happiness how are we going to have survey and have received an progressive welfare society, a gender blind, handicap overwhelming response from residents enjoy a high level blind society. The questions our members, once again of protection against social are many and the path to underscoring the deep interest and physical risks and the answers is complex. By each of us take in raising the benefit from of a range of 2050, India’s population standard of life. The survey public goods. over 60 years will equal was planned to get insights that of its young population into the following: Language: Language is up to 18 years. Given that the country is the largest What the Samarth members not just a communication democracy with 1.3 billion understand by the word tool; it is a culture bearer. people out of total 7 billion “happiness” in terms of Respecting the regional in the world, this is no relationships, engagement, language and preserving small number to consider. etc? the same leads to a better Unless the government and balanced society. the people take notice of What factors (physical, the impending situation, emotional, social) en- Liberal-mindedness: 30 years hence, there will courage them to consider be severe impacts across themselves “happy”? Liberal-mindedness is all aspects of life that is based on the premise that bound to affect the overall all people should have the standard of life across right to decide over their the country. One will not own lives. To demonstrate be surprised if India’s liberalism means having an happiness quotient dips open-minded and tolerant further. Many organizations attitude and mindset. There like Samarth, have taken are many other factors in play as well. Like the weather in the country, political stability, equal Vol 013| Issue 03 | samarth | 43

SURVEY/ INSIGHTS Nearly 86% were male and rest were female respondents. A deep dive into the 1,000+ responses highlighted a few fundamental beliefs: Happiness comes from choosing to be happy with whatever we do, strengthening our closest relationships and taking care of ourselves physically, financially, socially and emotionally. Researchers typically define happiness as a combination of three things: (1) overall life satisfaction, (2) the frequency and degree of positive emotions and (3) the relative absence of negative emotions. Researchers have found that we have essentially no control over roughly 50% of our happiness levels. 10% of happiness is determined by life circumstances (money, marriage, etc.) while 40% is determined by daily activities (how you think and what you do). One of the reasons for conducting this survey was to gain a deeper understanding of how we can better serve our members. Keeping this in mind, we divided the survey What factors (physical, emotional, social) lower their levels of “happiness”? What are some of the happy foods, happy days, happy colors for our members? How is happiness distributed across India, across gender, across age groups? 44 | samarth | Vol 03 | Issue 03

SURVEY/ INSIGHTS questions into three key buckets of physical, emotional and and social factors all play very social well-being. The results provided some unique insights important role in defining level and highlighted a set of key variables affecting the happiness of happiness in the golden index. For example, happiness is reported to be highest between years. However, even amongst 61-65 years and again picks up post 70 years. The members them, maintaining optimum below 55 years are generally reporting overall happiness physical health increases without showing any negative emotion. Members in the age the happiness by many folds group of 66 to 70 years reported to be in the lowest state of whereas lack of physical well- happiness. Living in areas with pleasant weather like close to being leads to equal decrease the coast, in a warm climate, and in an area with low wind are in the happiness. As per associated with increased happiness. No doubt the happiest most of the respondents, the nation in Asia is Bhutan. As per the survey insights, Jaipur is positive emotional factors the happiest city to live in surrounded by green cover, beautiful lead to the great increase architecture and rich culinary traditions. The city of Hyderabad in overall happiness in life. and Mumbai follow closely with good infrastructure, greenery, The most important factor places of tourism around and cosmopolitan workforce leading however is that of social to multiple opportunities to engage oneself. Contrary to popular engagement without which assumption, the city of joy, Kolkata appeared at the bottom of the seniors fail to enjoy their the list of happiest cities to live in. Geographically also people golden years. Paradoxically, responded differently to the question of overall happiness and trying to be happier forcefully content with life. While western and southern states reported can actually make you less higher happiness in life, the eastern states fared poorly. happy. This appears to occur because people who focus on There is also a significant gap between overall happiness happiness get disappointed and overall content with life. The gap may be pointing out the at times when they aren’t as underlying ambitions in people and the competitive nature of happy that they hope to be and urban life that we get to witness even in our golden years. But thereby become paradoxically life is not always about competition. Beauty lies in the eyes of less happy resulting in their the beholder and our seniors confirmed this statement with over lack of content with life. The 97% respondents saying that they find beauty in so many things key is to focus on the process around them. Similarly when asked about happiest day in their of making the happiness lives, most of the memorable occasions revolved around social activities a habit in daily life. gatherings like birthday and anniversary celebrations, travelling The results will follow. with family or spending time with grandchildren. Most of the seniors (nearly 37%) voted white as their favorite color followed by 26% voting blue and 13% saying green as their favorite. It is said that every city is defined by its culinary culture; most of our seniors, though they love to eat out but preferred home cooked meal as their happy food option. A critical insight that came out of the survey data analysis, was the fact that physical, emotional Vol 013| Issue 03 | samarth | 45

HEALTH, HAPPINESS AND HIGHER QUALITSURVEY/ INSIGHTS Y OF LIFE TREAT DEPRESSION STAY PHYSICALLY ACTIVE Stressful life events like retirement Keeps both body and mind feeling or losing a spouse. It could also be balanced and positive. caused by a medical disease or brain, sharpening the mind. It also . It’s relieves anxiety, tension, and even important to recognize the signs of depression! depression and get help from a Physically, exercise boosts the doctor or psychologist. immune system, lowers blood pressure, improves sleep quality, improves heart health, improves strength and stamina, and more! STAY MENTALLY ACTIVE LEISURE TRAVEL Crossword puzzles, sudoku, other Vacation can drastically lower stress brain games, reading, and writing levels, even after the vacation ends. are all great activities for mental Travel keeps seniors moving and stimulation. Having a sharp and active. active mind improves overall well-being. 46 | samarth | Vol 03 | Issue 03

SURVEY/ INSIGHTS FEEL USEFUL AND ENGAGED Help with tasks you can handle - Folding laundry Organizing drawers Opening the mail Writing grocery or household to-do lists Keep yourself up to date on the news Prepping dinner like trimming vegetables etc. Going with you to help shop for groceries or run other errands STAY CONNECTED WITH FAMILY, FRIENDS AND COMMUNITY Seniors who are isolated and lonely have shorter lives and are at greater risk for dementia. Prevent that by staying connected with people. Suggestions: Arrange for family and friends to visit, eat with, or go out regularly Encourage them to attend any get-together or parties Get yourself involved in a hobby Engage with local community actvities- temple/ church, read to children/ grandchildren or teach someone a skill or read and write Vol 013| Issue 03 | samarth | 47

TRAVEL If you love whisky, Scotland is like one big appreciation for local food, and two suitcases discovery montage. Across every single- groaning under the weight of the maximum lane bridge, around every bucolic bend, allowable quantity of whisky that one could sits yet another world-class distillery, take home without paying those exorbitant temples to whisky. You’re so spoiled for choice, baggage fees. Wherever possible, extra day it’s almost dizzying. In the late September was built in the itinerary making the pace 2018, Samarth followed this whiskey trail relaxed and enjoyable for the members. Here and organized a leisure week of exploring are a few key factors considered for making the United Kingdom from London to Edinburg; trip elderly friendly, easy to navigate through, from urban metropolis to the Highlands, enjoyable, and full of fantastic experiences: Islands, and Speyside regions of Scotland. The tour was designed with lot of care and 1. Avoiding main tourist season i.e. thought considering senior citizens and peak summer their preferences. Four members of Samarth community including Founder Director Mr. This ensured the places visited are not Asheesh Gupta travelled and came away with a crowded and the rates are economical deeper understanding of Scotch whisky, a new with flexibility of customizing the trip for individual elder’s preferences. 48 | samarth | Vol 03 | Issue 03 2. Avoiding popular hotels