Introduction About the organization

PREFACE
The health of older people has sometimes been treated as less important than that of younger people, either because older people are considered less productive or because ill health is deemed to an inevitable consequence of later life. Furthermore, older people are often regarded as a homogeneous group, which in turn conceals inequalities in this population. With these issues in mind my research project highlights the diversity of older peoples health needs and the health promotion issues relevant to later life. This study is a review entitled Caring process of senior citizens and it examined the inuence of the physical and social environment on older peoples health and highlighted gaps. This project goes beyond the basic descriptive analysis and looks deeper into the data and examines the diversity within older populations. This project have been subjected to multivariate analysis looking at a range of issues including diet, smoking, alcohol consumption and physical activity to identify the characteristics shared by those most likely to engage in health damaging behaviour. This qualitative investigation was commissioned to examine in detail the social factors that inuence older peoples health beliefs and health promoting behaviour. The aims of this study reects the Social strategy of developing the knowledge base of health promotion, and all those concerned with the health and well being of older people will nd in this report fresh and valuable insight into this diverse, under-researched and increasingly important population.

EXECUTIVE SUMMARY INTRODUCTION

In recent years, there has been an increase in interest in the health of older people. Policymakers and physicians recognize that the health expectancy of older people has not kept pace with increased life expectancy and a steady rise in the proportion of older people in the Indian population. In the early years of the century; attention focused on eliminating diseases of poverty, such as diphtheria and tuberculosis, and on improving the survival chances of infants and children. At the end of the century, a far larger proportion of the health budget is devoted to providing health care for people aged 50 years and older.

In order to assist health providers and policymakers to anticipate need among older age groups, extensive research has been carried out into the inuence which social factors have on the types of illness experienced in older age. However, little is known about the social factors which influence older peoples health beliefs and health promoting behaviours. Although the category older people spans two generations, it has been noted that among both health providers and health researchers it is common to treat older people as a homogeneous group sharing similar health experiences and attitudes. However, this ignores the way in which social factors such as ethnicity, gender, class; marital status and geographical location affect life and work experiences which, in turn, affect health experiences, behaviours and attitudes.

This qualitative investigation was commissioned to examine in detail the social factors that inuence older peoples health beliefs and health promoting behaviour. The aims of the study reect the social strategy of developing the knowledge base of health promotion in order to promote the development of conditions in which people and communities can take control over their own health.

Omashram Old Age Home Help us help the helpless elderly.

Omashram Trust is a charitable trust founded in the year 2001 with the objective of providing care and succor to the old. At Omashram Old Age Home we have 35 old, abandoned souls being cared for. The trust is now into the ninth year of its existence. The past eight years have been years of struggle and considerable odds to keep this fledgling institution afloat. We have been able to continue to do this good work through the benevolence extended by kind-hearted, altruistic individuals and corporate donors alike. Omashram provides residential care with full boarding & lodging facility to the old with medical care nursing care to the old belonging mostly to poor & middle class individuals (above 60 years of age) of all denominations At present the facility is housed in three separate rented premises all located nearby in the Vijaya Bank colony, Bilekahalli, Bannerghatta Road, Bangalore South. At present there are 35 residents. Unfortunately, this is the maximum capacity of the facility without cramming. It takes Rs. 5,000/- per month for us to ensure good health and food for one elderly individual in our Ashram. We invite all individuals who feel strongly for our cause to come forward and extend their support by donating in cash or kind or by sponsoring one resident of the Ashram.

Chapter- 2 Research Methodology Objective of the study Scope of the Study Research Methodology of the Study Research Tools

PROJECT OBJECTIVES
In India, it is becoming widespread as an accepted service to provide home care for the increasing number of elderly people by their family or by informal care givers. In this project, it is aimed to define the approaches of professional nurses and educators and the needs of the elderly; and find ways to solve the problems. The project is achieving this aim by the following objectives: - Conducting the needs analysis on local and national level to present the differences and similarities between informal care givers and the nurses in the partner countries as a key element of the Project To know the how long the elderly are staying at Om ashram To know are they getting proper food facilities or not To know about doctors visitings and medicine facilities To know the caring process adopted by the organization To know about elderly satisfaction about the organization To know about the care givers are giving proper assistance or not Scope of the Study To study in classroom for theoretical knowledge purpose is valuable but, it may be volatile. Therefore, it is necessary for practical assessment to make it in volatile. Attachment of student to any organization which provides students satisfaction at desired level. I got permission with project report to study on A Study on caring process of senior citizen Conducted at OM ASHRAM. I will try my best and I hope my completed report will help the students in future.

Statement of the problem The purpose of study is to being the gap between theoretical and practical concept. This study is carried out to analysis the A Study on caring process of senior citizen Conducted at Om ashram in BANGALORE and to understand the gap in caring process and the basic needs of the elderly people .

The other purpose of undertaken project is as follows To understand the caring process among elderly . To study about the basic need and scarcity of an individual. To know about the medicine as well as doctor facilities. To know about the satisfaction level by the elderly .

Research Methodology of the Study The different methodologies that I used to collect data from different places are given under: I have done my survey for collection of primary data. I used inter-net to collect the information of Om ashram. I got secondary data from Om ashram official. I got to know valuable informations from the residents.

Research Tools
Interview method Observation method Questionnaire method

Chapter-3

Review of literature
Older people's health beliefs older peoples health promotion behaviour

1. Conceptualizing health
This explores the way in which the older people dened the concept of health. In the majority of cases, perceptions of health and illness were influenced by the belief that although health and mobility problems are not inevitable in older age, they are certainly more common. Indeed, elderly had a variety of ailments which they and their doctors attributed to older age such as lateonset diabetes, cataracts, osteoporosis, arthritis and Parkinsons disease. Many of them also reported that the process of ageing seemed to have had an effect on both their mental and physical capabilities, with the result that they were more prone to memory lapses and to minor ailments and accidents. The majority of them viewed good health as the product of a symbiotic relationship between the physical, psychological, spiritual and social aspects of their lives, and believed that lack of harmony between any of these areas could lead to ill health. Very few of them dened good health and wellbeing as the absence of diseases. Indeed, some felt that it is possible to have a life threatening medical condition yet to feel healthy and reasonably contented with life. A female elderly shared her view that the key indicators of good health are having the ability, energy and self- motivation to carry out the daily necessities of life unaided, such as washing and dressing oneself, going to work, doing the household chores and socialising. The self-esteem generated by being healthy, independent and self-sufficient also enhances the feelings of emotional wellbeing. Another factor which was associated with feeling healthy in later life was the absence of severe physical pain. Aches and pains resulting from past injuries or deteriorating joints were seen as an inevitable consequence of the physiological process of ageing. If the sufferer could still carry out routine daily tasks, nonepainful ailments and stiffness in the joints were not viewed as poor health. However, people experiencing the intractable pain of chronic rheumatoid arthritis were more likely to describe their health as poor than elderly with life-threatening ailments whose pain was well managed. Regardless of their levels of perceived and received support, participants with severe chronic pain generally felt that they lacked all the criteria of good health, that is, the ability, energy and self-motivation to carry out the necessities of daily life. Indeed, the majority of the elderly who described their health as poor were from the 75+ age group and were experiencing intractable pain, or had other debilitating symptoms such as breathlessness. It was evident that elderly parents, especially if they are widowed, prefer to live with one of their sons whose wife is expected to care for them as well as her own family. Some of the elderly were caring for their parents or parentsin-law. This caused increased stress levels for participants who were daughters- in-law of die family and for the older men and women who were being

cared for, some of whom felt that they no longer had opportunities in the home to keep active or to make themselves useful, Furthermore, although this was not an issue in the present study; informants point out that the relationship between mother-in-law and daughter-in-law is often poor.

2. Factors which affect health in older age

This examines a number of factors which can affect the experience of health in older age, focusing on the links between structural and cultural factors, life events, personal circumstances, and behaviour. 1 Structural and cultural factors This section examines variations in the life and health expectancy of older people, and the way in which ageist perceptions of the characteristics of older people affect their social position. In addition, it examines cultural variations in beliefs about health in later life.

Since the turn of the century; the proportion of older people in the India population has been rising steadily; and is projected to rise still further. This is due to a number of factors including falling birth and death rates, and increasing life expectancy as a result of a higher standard of living and increased welfare and medical services. Despite their growing numerical strength, however, older people continue to be perceived as a minority, as a social group, their characteristics, needs and attitudes are assumed to be signicantly different from those of the rest of the population. For example, older age is associated with an increased risk of physical and mental health problems, and with disability, dependency and death. Older people continue to be stereotyped as dependent, senile and institutionalized, and as a burden on their families and the welfare state. Ageism, that is, stereotyping people on the grounds of age, contributes to age stratification and structured dependency throughout the industrialized world. As a result of this, both the young and the old are denied status and responsibility. For example, younger people are assumed to be careless and unreliable, and older people are assumed to lack stamina and mental agility; furthermore, the oldest members of society are assumed to be as incapable of looking after themselves as the youngest. The devaluation of older people results largely from the process of industrialization and the development of the waged economy. The onset of old age signals the imminence of senility; disablement and death, older individuals are expected to disengage from social life, that is, to relinquish their social roles and their position in the workforce in favour of younger people.

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In comparison, status and value tend to increase with age in non-industrialized societies. In such societies, older members of the community work for as long as they are able; they are assumed to have greater wisdom by virtue of their life experience, and are asked for advice when major decisions have to be taken. In industrialized societies, however, older peoples knowledge and skills are often seen as out of date and irrelevant, particularly in the modern workplace. Furthermore, older people are perceived as non exible and unable to cope with the fast pace of social and technological change.

Ageism The ndings of the present study indicate that the views of many of the elderly were inuenced by ageist perceptions and attitudes. For example, there was a widespread expectation that. Increasing age would lead to senility, disablement, dependency and, possibly, the need for residential care. However, some elderly were aware that internalized ageism, combined with the ageist attitudes of younger people, can lead t and able older people into a state of dependency In general, these elderly believed that dependency results not only in physical inactivity, which can have negative consequences for general health, but also in loss of self condence and self-esteem which can have a negative impact on emotional wellbeing. Some elderly felt that in their communities people generally achieve higher status and responsibility as they grow older, especially men. Nevertheless, enhanced status can also result in older people becoming dependent because younger people are obliged to demonstrate the respect they have for older relatives by providing for all their material and personal needs.

Some older people, especially women, insist upon receiving a high level of care because they devoted much of their youth to caring for older relatives. A few of the elderly women had been obliged to give up their careers and their lives outside the home in order to care for parentsinlaw who, in some cases, were well able to look after themselves. For some elderly, these age-related changes in the pattern of their lives brought about feelings of loneliness, worthlessness and apathy. Indeed, several of the elderly women from the older age groups had disengaged from social life to such an extent that they felt that their lives no longer had any purpose other than to make spiritual preparations for death.

This was a key area of discussion among the female elderly. Many older men also believed that cultural traditions which result in inactivity and dependency can have a negative impact on

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health and wellbeing in later life. Financial circumstances Elderly felt that certain features of Indian family life can help to enhance health and feelings of wellbeing. A large number of elderly felt that having an income just above the level at which they were eligible for state benets was the cause of serious money worries for many of their clients. It was pointed out that being in receipt of an employers pension could deprive an elderly of nancial and welfare benets worth hundreds a year. Furthermore, it was felt that dealing with bills and nancial paperwork could be an additional source of worry, especially for the very old.

Nevertheless, some participants mentioned that they never had holidays or trips away from home. Several participants from rural areas who were t and able to lead a full and active social life were prevented from doing so because bus services were inadequate and they could not afford the cost of transportation. Less able participants in rural areas reported data they often put off going to the doctor, optician and chiropodist not only because of the cost of the treatment but also because of the cost of transport. Furthermore, the majority of elderly in both rural and urban settings were afraid to go out at night on foot, thus unless they could afford a vehicle, the cost of taxis prevented them from going to temples, sat-sangs or the social events in the evening, except on rare occasions, Participants made the following comments about the way in which being unable to afford transport affects wellbeing and quality of life. However, in some rural areas there were thriving government organizations in operation which, as long as older people were aware of them, could provide free or modestly priced doorto door transport to hospital appointments. Older people living in inner cities generally felt that, during daylight hours at least, they were well served by public transport. All had governmental passes allowing them to travel free or for reduced fares. Apart from those living in isolated rural areas, the most disadvantaged participants in terms of transport were those who lived on outercity estates with few local amenities.

Elderly who lived in their own homes also mentioned the worry of maintaining their properties and making repairs. Many people received help from family and friends. However, a few participants were unable to carry out their own decorating or to look after their gardens but could not afford to pay someone to do these tasks for them. Most were distressed by their deteriorating appearance of their homes, and were worried that the neglect would cause structural damage and damp. In comparison, people who lived in sheltered accommodation and in residential care were

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relieved of these anxieties. Personal safety and security As a result of media publicity about criminal incidents, the majority of elderly felt that they were more vulnerable to crime, sudden illness and accidents now that they were older, Thus, enhanced personal safety was frequently cited as an additional advantage to living in sheltered, residential and warden-assisted accommodation in later life, although a number of people reported that determined thieves can nd a way into even the most secure places. Likewise, people living on the ground oor in both private and sheltered accommodation felt that they were more vulnerable to burglary and attack than people living on the rst oor and above. Some elderly felt safer, especially at night, as a result of knowing that there was a security on the premises to help them in an emergency. There was a widespread fear among elderly that they might collapse or die, and that no one would nd them for days. Consequently, being regularly contacted by the security guard of the place of their residence, relative or neighbour gave people additional peace of mind.

The local environment In general, feelings of good health and well being were associated with living in a well maintained and well-equipped home in a quiet, clean environment. Elderly living in purposebuilt sheltered accommodation tended to be particularly happy with their environment; even where flats were located in inner-city settings, they generally had gardens which provided a pleasant outlook and enabled residents to sit outside in the summer. A small number of elderly who lived in run-down terraced houses and tower-block ats in inner-city areas also felt happy with their environment. This was largely because they had lived there for many years, knew all their neighbors and had a wide range of amenities nearby. In general, elderly felt safer and happier if they were part of a close-knit, supportive community. In general, the participants who were most satised with their environment were those living in rural areas, and those living in inner- city areas. Several elderly living in the urban were less happy with their environment and felt that they were more likely to be victimized by crime, and that they were being exposed to too much industrial and traffic pollution. They believed that they were at constant risk of crimes such as mugging and vandalism, and that they were sullering noise pollution as a result of children and young people gathering outside their homes.

The social environment Although all the people who lived on outer-city estates were liable to be disadvantageous by their poor environment. However, older people felt themselves to be trapped by lack of money

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and transport. Elderly who lived in sheltered or residential accommodation generally felt that peace of mind and reduced nancial outgoings outweighed the disadvantages of community living. Elderly acknowledged that organizations such as Age Concern provide a valuable service in terms of entertainment and welfare care. However, many preferred to be involved in organizing activities, preparing meals and acting as voluntary drivers for less able and active older people than themselves. However, elderly regarded voluntary work as any type of assistance given to other people. Thus, regardless of income and state of health, many of the men and women were going shopping or cooking meals for other people. In general, older people nd voluntary work and socializing with friends and relatives preferable to taking part in old peoples activities. Several elderly in the present said that they made a point of refusing invitations to join in activities which they perceived as being specially for old people. Preferring to remain at home or to make their own amusement. The oldest and least physically able elderly derived a great deal of enjoyment from activities organized for them. Some of the oldest elderly found that they had little in common with the other users of older peoples temples and sat-sang, but continued to go because it was an opportunity to get out of the house once or twice a week. The same complaint was made about the social life in nursing homes.

These comments were made by two of the oldest elderly both of whom felt lonely and isolated largely because it seemed to them that they were far more mentally alert and interested in life than most of their contemporaries.

Social isolation Loneliness was a key issue for most of them who were living alone. Self-assessments of poor health were closely associated with lack of perceived social support from family members, neighbours and friends. Conversely, self-assessment of good health in the presence of chronic or life-threatening ailments was associated with the availability of social support which enabled older people to remain active within their communities. Elderly generally felt less isolated if they lived in sheltered accommodation where they had regular Contact with their neighbours. All the elderly who lived alone said that they felt lonely from time to time, especially in the evenings, and some had the television switched on during all their waking hours. Some of the oldest elderly, and many of those with mobility problems, felt themselves to be isolated largely by the attitudes of other people.
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An elderly woman also felt that she had a poor quality of life. She was retired from work and lived alone. A lack of nancial resources meant that she had access to a physical check-up halfyearly that is once in six months and, apart from this, she had little social contact with others Although the number of people living alone in later life is steadily rising, this does not necessarily indicate a trend towards the wholesale neglect and abandonment of older people by younger members of society. In some of the cases, older people live alone by choice because they want to, because they have the means to do so and because they prefer to be independent. It was felt that it is important for older that they are treated as capable and able adults, and that unwanted help and attention are not forced on them, however frail they may be. The majority of the elderly in the present were determined to remain independent, and to do as much as possible for themselves. A number of participants felt that a degree of loneliness was the price they had to pay for maintaining their independence in their own homes. Nevertheless, knowing that practical help, emotional support and companionship were readily available if required contributed in great measure to feelings of general wellbeing. Many t and able elderly felt that they beneted from being able to offer help and support to neighbours and younger members of the family by doing their shopping, babysitting and lending a sympathetic ear in times of trouble. Less ablebodied elderly welcomed the practical help and emotional support that they received from neighbours and friends. Several elderly made the point that the need for companionship in later life varies considerably from day to day, and from person to person. The majority of elderly were satised with the level of contact they had with neighbours and relatives. However, many men and women missed the quiet, undemanding companionship that they had enjoyed with a significant other, such as their spouse, a friend, a child, a parent or a sibling; that is, the type of relationship in which they could talk if they felt like it, or remain silent without causing offence. Some elderly felt that, as they had become more housebound, they had lost control over their social lives.

Thus, when elderly spoke of loneliness some made it clears that they did not necessarily mean the complete absence of social contact but the absence of the right kind of social contact, that is, social contact on their own terms, and with people with whom they had something in common other than family ties or old age. Others spoke of the value that they placed on friendship, because their friends were the people with whom they chose to socialise. However, several elderly were aware that the range and quality of their social relationships, and their choice of companions, were steadily dwindling as they became older.
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The elderly, who tended to feel most lonely and isolated, despite seeing care workers or neighbours almost every day, were those who had no relatives living near to them. Some people had children or siblings who had migrated whom they had seldom seen since, although they wrote to each other and spoke regularly by telephone. Several elderly felt particularly isolated at festival time, when they were aware that other older people were visiting or being visited by their families. 2 Life events and personal circumstances This examines elderly beliefs about the way in which life events and personal circumstances might affect the health and wellbeing of elderly. The following events and circumstances are discussed: Caring for a partner or family member Bereavement Retirement Past or present occupation Mental health Early life experiences Caring for a partner or family member The consequences for health and wellbeing of caring for elderly parents-in-law, and being cared for by ones daughter-in-law, were discussed at length, particularly amongst the female participants. In the general focus groups and interviews, being responsible for the care and support of a terminally ill or disabled family member was also Felt to have a negative impact on health and wellbeing. Many elderly felt that the experience of caring for a partner or relative over a long period of time in later life resulted in a decline in their own health.

Despite of the negative health effects of being an older carer, some participants found that the experience enhanced their wellbeing, as a result of having the constant companionship of a loved one. Furthermore, several men believed that caring for someone later in life had been a positive experience because they enjoyed the challenge, and it gave them a sense of purpose at a time when it seemed that their useful life was coming to an end.

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Bereavement Many participants felt bereft of a special kind of easy and relaxed companionship when they lost their partner or a friend or relative with whom they had lived for many years. these feelings of loss and loneliness were, in many cases, tempered by relief and a sense of freedom, especially for some of the female elderly. Several women spoke of the sense of freedom they derived from not having to cook meals three times a day, and both men and women enjoyed being able to do as they liked without having to defer to anyone elses Wishes. In general, however, elderly were saddened by the loss of their close companions, and a small number felt that they would never get over it. The long-term effects of bereavement included loneliness and a feeling of depression, but the most common immediate response to the death of a spouse or close friend was to withdraw from social life. Some elderly had become so withdrawn that they needed the help of friends, relatives or professional counselors to recover.

Although elderly felt that bereavement affected their emotional wellbeing, only a small number of people felt that their physical health had been damaged by the death of someone close to them; for example, this woman attributed her worsening heart problems to grief following the death of her son.

Retirement There were gender differences in beliefs about the way in which retirement from work has an impact on health and wellbeing. Male participants were more likely to report that they felt depressed after retirement than women, most of who had welcomed it, or were looking forward to it, as an opportunity to pursue their own interests. In general, the health effects of retirement were thought to be inuenced by the reason for retirement, that is, elderly felt that being obliged to leave work early was more likely to lead to depression than leaving voluntarily, or at statutory retirement age. Early retirement was often regarded as a euphemism for redundancy, and elderly felt particularly bitter if they and their skills were dispensed with while younger and less well qualied staff were retained.

Some elderly felt that older people could become isolated and lonely after retirement and it was also widely felt that, for men in particular, retirement could lead to such a decline in spirits and health that they died soon afterwards. In the experience of a number of male elderly, being constantly in the company of their wives had led to arguments, especially if both partners were conned to the home by illness or disability. Among the female participants, some felt that their personal freedom was curtailed once their husbands retired; they had to account for their
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movements during the day and spend more time looking after their husbands.

However, the majority of elderly had enjoyed the period since they or their husbands had retired from work because although their incomes were reduced, it released them from the drudgery and stress of work. Many elderly also enjoyed having more time to spend with their families and having the opportunity.

Past or present occupation Some of the elderly had been retired for many years; consequently; their previous occupation seemed to them to have little bearing on their present health experiences. However, a number of elderly believed that a persons occupation could affect their health in later life, particularly if it brought them into contact with dust or dangerous chemicals, or put them at risk of accidents. In terms of their own personal experience, elderly who felt that their health had been damaged by their working environment were generally women, unskilled or semi-skilled workers. Elderly who felt that their health had been adversely affected by stress at work were generally men, managers, professionals or the owners of businesses.

Mental health This issue was raised by a number of elderly who felt that regardless of a persons state of physical health and mobility in later life, their wellbeing and quality of life could be affected by a decline in mental health. Elderly did not believe that mental health problems were an inevitable consequence of ageing. Many participants in the general associated Alzheimers disease and senile dementia with old age and were fearful of developing these conditions because of the implications for independence, self control and dignity. Some participants had suffered mental health problems, such as depression, but had not realised that they were ill until their friends or relatives urged them to seek medical advice. This nding suggests that mental health problems among older people may be exacerbated by lack of social support. Mental health problems were associated with bereavement and with personal circumstances such as marital problems.

Elderly believed that there is less sympathy for, and understanding of, mental health problems than other forms of ill health, even among the medical profession. Some elderly spoke of the difficulties they encountered in obtaining a diagnosis tor a relative with symptoms of Alzheimers disease or senile dementia. In a number of cases, symptoms of serious degenerative mental health problems were dismissed by GPs as a natural feature of the ageing process; thus,

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relatives felt they were being denied the assistance they needed. Some elderly believed that health was the product of an interaction between the physical and the spiritual and mental aspects of their lives; thus, many believed that there is a relationship between physical health and mental health problems such as depression. Some elderly also mentioned disturbed sleep in the context of mental health problems, and felt that the quality of ones sleep in later life can affect health and wellbeing. Some elders felt that spiritual and mental healths are closely related; thus, having a troubled conscience leads to nightmares which are the principle cause of disturbed sleep.

Early life experiences A number of participants felt that experiences in childhood, such as physical cruelty, deprivation and an inadequate diet, could have an effect on health in later life. 3. Personal behaviour This examines the extent to which elderly felt that peoples past and present behaviour effects their health and wellbeing in later life. It is focused mainly on the effects on health of eating, smoking and drinking alcohol.

Diet and nutrition Participants believed that nutrition is one of the most important inuences on health and wellbeing throughout life; for example, loss of appetite was regarded as a major symptom of ill health. Furthermore, eating snack foods and eating irregularly were thought to cause health problems.

In general, some elderly perceived eating and drinking as social activities; they were extremely interested in food and spoke about their eating habits. Most believed that eating regular meals gave structure to their day; and several found cooking an enjoyable pastime. Although some elderly felt that they were unable to afford a good-quality diet, the majority believed that diet were eating nutritious food and in sufficient quantities to satisfy their appetites. Indeed, a number of elderly, especially those who were housebound, spent a large proportion of their income on food. In some cases, people felt that there was little also in their lives that gave them as much pleasure as eating and drinking their favourite things, including sweets, chocolates, wine etc. In general, elderly felt that they knew what constitutes a good and bad diet, for example, that fruit and vegetables are benecial and that items such as chocolates and cakes are unlikely to promote good health. However, non-diabetic participants generally felt that, at their age, little

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harm was likely to result from indulging in treats containing high levels of sugar and fat as long as they also ate plenty of fibre, vegetables and fruit. The majority of elderly in the general felt that there was no harm in drinking alcohol in moderation. Some had seen recent media reports that a glass of red wine a day is good for health; others felt that a drink before bedtime gave them a better nights sleep. Many people felt that having a drink with friends was an important feature of their social lives, and particularly enjoyed wine with meals.

It was found that there were class differences in beliefs about the nutritional value of different types of food. For example, working-class women believed that meals should be substantial and lling, whereas middle-class women placed more emphasis on a balanced diet and everything in moderation; it is found that both groups believed it was important to eat fresh rather than processed or packaged food. ln the present study, regional differences were more marked than class differences, with elderly from all social groups in the North placing more emphasis on the importance of having hot meals. In the present study; participants also differed in their attitudes regarding the nutritional value of processed foods. Many men and women, particularly those in the older age groups, argued that packaged meals are more convenient, more economical and just as nutritious as meals cooked from scratch using fresh ingredients A large number of participants, particularly in the older age groups, were using microwave ovens for most of their cooking and found that heating readymade meals involved them in less standing and used far less fuel; in addition, the small portions and strong flavours of many ready-meals suited those with smaller appetites and a reduced sense of taste and smell. A further bonus for older and frailer elderly was that a week's meals were light to carry and could be stored in a small freezer or cupboard. The consensus view was that processed foods benet older peoples health because without the convenience of readymeals and the microwave, many people would probably live on soup and sandwiches.

Widowed female particularly enjoyed having the option of using convenience foods after many years of cooking meals for their husbands and families. However, the majority of elderly who made extensive use of processed and micro waved meals believed that it was important to supplement their diet with fresh fruit and vegetables. Overall, this set of ndings suggests that there is a contradiction between beliefs and behaviour. Elderly believed that a nutritionally balanced diet is important yet their comments suggested that they would be willing to forgo the health benets of a cooked meal if this involved them in too

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much expense or effort. Most of them believed that fresh food is more nutritious than processed food. A number of people believed that fresh food is of higher quality. Some of them were of the view that the impact of diet and food on health was inuenced, in many cases, by the belief that certain foods have therapeutic properties. some foods were perceived as being more digestible, nourishing and strengthening than others, particularly for older people. Strong foods, perceived as energy-giving, were considered health-giving and powerful for the healthy body but liable to produce worsening of illness in those debilitated by age or illness. Weak foods, preferred in the everyday menu and for the old or feeble, included boiled rice and cereals.

The digestibility of food was considered to be related to the cooking method, with boiled and steamed foods were classied as easy to digest and raw, fried or baked foods hard to digest. The former were considered suitable for the elderly, inrm and young while the latter were preferred for healthy adults. In general, elderly felt that good quality food, together with the activities of cooking for the family and eating meals together. promotes wellbeing. However, some elderly felt that they were probably buying, cooking and eating more food than was good for health, and several men and women had digestive and cardiovascular problems which their GPs had told them were caused by too much fatty and heavily spiced food.

Habits Elderly believed that habits such as drinking alcohol, smoking tobacco and taking drugs could have negative effects on the health of people of all ages. None of the men and women felt that they were consuming too much alcohol. However, a small number of people believed that they were probably addicted to sleeping tablets, and smoking. A number of elderly were ex-smokers and, of these, the majority had stopped smoking on a sudden whim without experiencing any major withdrawal symptoms; several men used the same terminology to describe how they gave up, that is, I just woke up one morning and didnt want to do it anymore. In a small number of cases, elderly had given up smoking because they had bronchial or heart problems, or because they could no longer afiord it; in an equally small number of cases, participants continued to smoke despite having serious cardiovascular problems. The material circumstances are a major inuence on smoking habits. Smoking appeared to be used by working-class men as a resource for relaxation and for handling the stresses and strains
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of everyday life. Some showed ambivalent attitude towards the habit; most acknowledged that it was probably bad for their health, yet none was prepared to give it up. Some felt deant in the Face of so much criticism of the habit, and refused to give up. Others felt that their health had not been damaged at all by smoking or, conversely; that their health had been irreparably damaged so there did not seem any point in giving up. Some people felt that smoking was one of the few pleasures they had in their lives, and others smoked for something to do. A number of elderly notably smoked because they Felt it helped them to cope with problems or unpleasant living circumstances. Some elderly smoked for therapeutic reasons, for example, to aid digestion; furthermore, smoking was often perceived as a social activity, and was carried out in a group setting with other men.

3. Control over health in later life This reveals the extent to which the older people believed they had control over their present and future state of health. As the elderly had individual health beliefs and behaviours arc inuenced not only by personal circumstances and experiences but by a wide range of social and cultural factors, including beliefs about the social worth of older people and expectations about how they should behave. For example, older people may internalise the view that the elderly have less social value than younger people and therefore have less claim on valuable and scarce resources such as good quality housing and health care. They may also internalise the view that old age is a period of life in which they must expect to experience more ill health, decreased mobility and a steady decline in their mental faculties. Furthermore, older peoples behavior may be inuenced by the view that, in later life, it is inappropriate for people to retain control over their own lives, or to be active, lively and exuberant.

The health locus of control thesis seeks to explain health-related behaviour in terms of individuals beliefs about the level of control they have over their health rather than in terms of the degree to which they believe they are at risk of disease; if individuals feel that they have little control over their health, this may discourage them from following health promotion advice. Regardless of class, location, age and level of education, everyone believed that chance, or God, plays some part in determining health in later life. Elderly believed that health is largely determined by luck. In general, however, elderly believed that some older people have worse health than others because the odds were stacked against them from the start, for example, by being born into a poor family or a family with a genetic predisposition to diseases such as cancer. Likewise,

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through no fault of their own, some peoples health has been irreparably damaged because they had accidents, caught contagious diseases or lived and worked in dirty, polluted environments. Some participants believed that behaviour could affect. health; thus, drug addicts, alcoholics and heavy smokers tempt fate, or squander the gift of good health that God has given them. Furthermore, there were differences in attitude in terms of age, and of educational achievement. Some elderly from higher socio-economic groups had experienced poverty and deprivation in childhood; most had left school without qualications between the ages of 12 and 15, although a few had later acquired educational or professional qualications at night school. Thus, a number of the elderly were self-made man in terms of socioeconomic status, and several other elderly from lower socioeconomic groups were, by their own denition, self-educated. Some elderly those with a higher level of education generally took the view that health in later life is determined by individual behavior coupled with luck or the will of God. Thus, it is possible to improve ones quality of life and general wellbeing by paying careful attention to diet and exercise, even though it may not be possible to prevent ill health altogether since this is a matter of chance or is preordained by God or fate.

However, other participants generally felt that with the exception of minor illnesses such as colds, there is little the individual can do to inuenee his or her health in later life. Thus, it is better to let medical experts deal with health matters. Some elderly felt that doctors are not infallible and that each individual is the expert on his or her own body; thus, although people may not be able to prevent illnesses from occurring, they should retain as much control as possible over their medical treatment.

Part 2 Older peoples health promotion behaviour This reveals the extent to which the older men and women who took part in the study practise health-promoting behaviours, and identify the sources from which they obtain their information about health. We then examine the factors which encourage older people to comply with health promotion advice, or deter them from behaving healthily.

4 Healthy behaviour in older age This involves the ways in which the older men and women who took part in the study dened healthy behaviour, and the importance which they attached to having a healthy lifestyle. Many of the participants believed that although it may not be possible to prevent ill health altogether in later life, behaving healthily can enhance Well-being, for example by improving mobility and

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making people less susceptible to minor ailments such as coughs and colds. However, although a number of elderly made scathing comments about individuals who tempt fate by neglecting themselves or practicing risky behaviours such as smoking, the majority believed that people should be free to do as they please with their own bodies. Elderly dened healthy behaviour in later life as doing ones best to achieve any or all of the following: Remaining mentally and physically active Having a nutritionally well-balanced diet Eating and drinking in moderation Avoiding risky behaviours such as smoking Having a positive mental attitude Interacting regularly with other people Consulting a medical practitioner about worrying symptoms Having regular routine health checks Following expert medical advice. The importance of behaving healthily in later life The importance which elderly attached to healthy behavior varied considerable from person to person, and was often linked to the experience of ill health. One elderly in her early 70s who had recently had a mastectomy believed it was essential for her health to take part in exercise classes several times a week. Other women of a similar age who had not had major health problems felt that doing their household chores was sufficient exercise.

Likewise, people who had experienced digestive or cardiovascular problems, or diabetes, attached more importance to the whole family eating a carefully balanced diet than people who had not shared these experiences.

Making changes in health-related behaviour Other participants who did not have health problems had tried to make an effort to live a healthier lifestyle, but had failed to maintain the changes, for example, in trying to eat a more balanced diet:

Many elderly resolved this dilemma by moderating their intake of foodstuffs which they considered were bad for health in large quantities. This strategy was felt to be more manageable
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than cutting out certain foods altogether, and such explanations were often accompanied by the maxims A little of what you fancy does you good, and Everything in moderation. However, other elderly offset failure to make healthrelated changes in one area with additional efforts in areas where they had been more successful. However, a small number of participants felt that their attempts to make health-related changes in one area of their lives were causing problems in others. Some of the elderly also felt that there were cultural barriers to healthy behaviour such as taking purposeful exercise. There were some elderly who felt that they had always led healthy lives, or had successfully incorporated health- promoting behaviours into their lifestyles. In general, elderly had managed to establish new habits because they were encouraged by experiencing positive changes in their health and wellbeing. One man in his late 80s who had been unable to rise from his chair without assistance before joining an exercise class was now able to walk to the shops; this man and his wife, who had recently taken up allotment gardening, had noticed health benets in terms of mobility, diet and wellbeing. Other elderly reported improvements in their health as a result of making modest behavioural changes, such as continuing to eat much the same diet as before but substituting low-fat products where possible and adding bre-rich cereals, nuts, pulses and fresh fruit and vegetables. The importance of positive mental attitude Most of the activities which elderly dened as healthy behavior were relevant to the health and wellbeing of people of any age. However, elderly felt that it was particularly important for the promotion of good health in later life to mix with other people on a regular basis, and to maintain a positive mental attitude. These two aspects of healthy behaviour were believed to be closely related since people with nothing to look forward to, such as visits from friends and family, or social outings, were likely to become depressed, lethargic and less inclined to take care of themselves or to seek companionship.

Furthermore, people with a negative outlook on life were often spurned as companions by others; for example, many elderly said that they avoided the company of other older people who, in their opinion, moaned too much" or were miseries. Seeking medical advice It was noted that some of the older men and women felt that their medical advisers were in control of their health. However, it was not always the case that the practitioners consulted by elderly were qualied in Western medicine. Many of elderly had consulted practitioners of

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traditional medicine. Several elderly had also consulted acupuncturists, practitioners of traditional Chinese herbal medicine, aromatherapists, homoeopaths and hypnotherapists. Although the majority of elderly were pleased with the service they received from their practitioners and from the hospital service, there was a degree of reluctance to consult their practitioners among members of the general sample as a result of perceived ageism; this issue was discussed by the elderly were generally satised with the medical services they received. However, although all the older men and women felt that this did not necessarily make their doctors more understanding of their problems. The medical practitioners are generally so highly regarded in the elderly community that they are consulted for every incidence of ill health, however minor. One of the elderly made the same point, arguing that she thought people should be prepared to take more responsibility for looking after their own health. Indeed, a large number of elderly indicated that they did not feel that they had received proper treatment if they were given health promotion advices by their practitioners rather than a prescription. Thus when elderly spoke of advice from their practitioners they generallv meant following the instructions they were given about taking medication.

However, some elderly, notably men, preferred to try traditional remedies instead of, or in conjunction with, Western medicine by using herbal medicaments or by visiting a healer; Hindu and Sikh elderly consulted their guru (spiritual adviser) and Muslim elderly consulted a Pir (spiritual healer).

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DATA ANALYSIS AND INTERPRETATION

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1) Since how long you are staying Om Ashram? Years 5 years 10 years 10 years and above No of Residents 18 12 0

12 5 year 18 10 year above 10 year

Interpretation In the above figure shows taken as a sample size. The total sample size is 40 which when taken as 18 Resident are living past 5 years and remaining 12 people staying since last 10 years at Om ashram.

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2) How you are utilizing your time here? Time utilization mediums Reading watching television doing useful work contributing utility to the organization No of Respondents 10 22 5 3

10 watching Tv doing useful work

Reading

22 useful work contributing to the organisation

Interpretation In the above figure shows taken as a sample size. The total sample size is 40 which when taken as 10 Resident are reading books,22 are utilizing time by watching television and 5 resident doing some useful work as per daily routine and remaining 3 people are contributing their time for organizational work at Om ashram.

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3) How frequently you are getting your medical checkup? Check up Yearly half-yearly quarterly monthly No of Responses
2 1 10 27

1 2 10 27 yearly half yearly quarterly monthly

Interpretation In the above figure shows taken as a sample size. The total sample size is 40 which when taken as 27 Resident are getting monthly checkup ,10 resident by quarterly, 1 person by half yearly and remaining 2 resident getting yearly checkup at Om ashram.

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4) Are you regularly counseling by the volunteers?

Yes No

36 4

yes No 36

Interpretation In the above figure shows taken as a sample size. The total sample size is 40 which when taken as 36 Resident are saying yes and remaining 4 resident saying No.
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5) If unwell or drug should be taken regularly are you reminded by the volunteers

Yes No

38 2

Yes No 38

Interpretation In the above figure shows taken as a sample size.

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The total sample size is 40 which when taken as 38 Resident are saying yes and remaining 2 resident saying No.

6) Are you getting the medicine regularly? Yes No

32 8

yes No 32

Interpretation In the above figure shows taken as a sample size.

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The total sample size is 40 which when taken as 32 Resident are saying yes and remaining 8 resident saying No.

7) Are you emotionally satisfied by the welfare measures? Yes No

12 28

12 yes No 28

Interpretation In the above figure shows taken as a sample size. The total sample size is 40 which when taken as 28 Resident are saying yes and remaining 12 resident saying No.
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8) Are you participating in vocational training which is comfortable to you? Yes No

15 25

15 yes 25 No

Interpretation In the above figure shows taken as a sample size.

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The total sample size is 40 which when taken as 25 Resident are saying yes and remaining 15 resident saying No.

9) Are you involved in any social welfare organization?

Yes No

9 31

yes 31 No

Interpretation In the above figure shows taken as a sample size.

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The total sample size is 40 which when taken as 31 Resident are saying yes and remaining 9 resident saying No.

10) Have you felt any day the food you take is not nutritional? Once in a weak Frequently Not at all
12 18 10

10

12 once in a way frequently 18 Not at all

Interpretation In the above figure shows taken as a sample size.

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The total sample size is 40 which when taken as12 Resident are saying once in a way and 18 are saying frequently and remaining 10 resident saying Not at all.

11) Are you encouraged to helping your inmates in time of needs? Yes No
12 28

12

yes 28 No

Interpretation In the above figure shows taken as a sample size. The total sample size is 40 which when taken as12 Resident are saying yes and remaining 28 resident saying No.

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12) How are you rating the organization in terms of your happiness? Excellent Good Fair
28 5 7

7 5 28 Execellent good fair

Interpretation In the above figure shows taken as a sample size. The total sample size is 40 which when taken as 28 Resident are saying excellent, 5 are saying good and remaining 7 resident saying fair.

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13) Do you like to stay here life long? Yes No

27 13

13 yes 27 No

Interpretation In the above figure shows taken as a sample size. The total sample size is 40 which when taken as 27 Resident are saying yes and remaining 13 resident saying No.

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14) Overall satisfaction with Om Ashram? Strongly agree Agree Neutral disagree strongly disagree
12 6 7 9 6

6 9

12

strongly agree Agree Neutral 6

Disagree strongly disagree

Interpretation In the above figure shows taken as a sample size. The total sample size is 40 which when taken as12 Resident are strongly agree,6 are agree,7 are neutral,9 resident are disagree and remaining 6 resident saying strongly disagree.

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RECOMMENDATION

We give the following suggestion that can be implemented to increase the elderly satisfaction and the profitability for the organization. By maintaining proper assessment of elderly To provide them good moral and emotional assistance to encourage the confident level among elderly To provide them proper food nutrition and medical assistance to enhance their satisfaction about the organization. To give them vocational training like yoga ,meditation ,etc

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FINDINGS
During this social involment project I found that most of the elderly people they want proper assistance by the volunteers, and some of them are mentally effected and not able to follow their daily life routine. During this social involment project I felt that most of the elderly are ready to go back their home but their families are not ready to take back these people to their home. In this organization I found that most of the elderly they want to talk with people but the main thing is that people are busy in their own life they have a close knit routine/scheduled life.

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CONCLUSION
During this social involment project among senior citizen I can some up that this project has many things that cannot be change by anyone .in this study I conclude that is the elderly are less likely to make changes in their daily life or health related behavior it is therefore suggested that steps should be taken to ensure a good health and caring attitude towards the elderly.

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REFRENCES www.Omashram.org

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Appendix QUESTIONNAIRE
NAME AGE: 50 Yrs to 60 Yrs 60 Yrs to 70 Yrs Above 70 Yrs GENDER A) Male B) Female RELIGION a) Hindu b) Muslim c) Christian

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QUALIFICATION a) Below 10th standard b) PUC level c) Degree d) Post Graduate level e) Professional OCCUPATION a) Private Employee b) Government Employee c) Business

MARITIAL STATUS a) Married b) Unmarried c) Divorce

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General aspects: 1) Since how long you are staying Om Ashram. a) 5 year (b) 10 year (c) above 10 year

2) How you are utilizing your time here? a) reading b)watching television c) doing useful work d) useful work contributing utility to the organization 3) How frequently you are getting your medical checkup? a) Yearly b) half-yearly c) quarterly d) monthly

7) Are you regularly counseling by the volunteers? a) Yes b) No

8) If unwell or drug should be taken regularly are you reminded by the volunteers a) Yes b) No

9) Are you getting the medicine regularly? a) Agree b) disagree

10) Are you emotionally satisfied by the welfare measures? a) Yes b) No

11) Are you participating in vocational training which is comfortable to you? a) Yes b) No

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12) Are you involved in any social welfare organization? a) yes b) No

13) Have you felt any day the food you take is not nutritional? a) Once in a way b) Frequently c) Not at all 11) Are you encouraged to helping your inmates in time of needs? a) yes b)No

12) How are you rating the organization in terms of your happiness? a) Excellent b) good 13) Do you like to stay here life long? a) Yes b) No c) fair

14) Overall satisfaction with Om Ashram a) Strongly agree b) Agree c) Neutral d) disagree e) strongly disagree.

Thank you.

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