1. Introduction:
Old age means reduced physical ability, declining mental ability, the gradual giving up of role
playing in socio-economic activities, and a shift in economic status moving from economic
independence to economic dependence upon other‟s for support. Old age is called “dark” not
because the light fails to shine but because people refuse to see it (Gowri 2003).
Old age can be called as the near end of the life cycle of any human being. This is the time of
(human) life at which corrosion and fall of physical abilities including sight, hearing, walking
(stick required), etc. get started. This age is considered as the dependent age and also non
economic age due to deterioration of physical abilities. This is the time at which a person gives
up work as age does not allow him to do as much work as he was able to do in his young life. In
general, the age of 65 years and above is considered old age in present times. This age is about
60 years in Pakistan. The proportion of old people in the total population in the developed world
and even more rapidly in many developing countries is rising due to improvement in health
facilities. The basic requirements of old people today are their better care in terms of their social,
health and financial security. It is realized all over the world to do care of old people and to
provide them with their basic needs and independence (either economically or any other) as their
basic right. This problem is also being attended by world‟s international organizations as well.
(Azam, H., et al. 2012)
There are different ways to provide them with some basic needs. There are pension schemes to
make them economically independent whereas a pension is a steady income given to a person
usually after retirement. There are old homes to provide them with some sort of shelter, food and
basic facilities of life. Family is the main source of care giving to all its members. One‟s need for
and ability to give care is negotiated by one‟s place in family life cycle. Ageing of population is
an obvious consequence of the process of demographic transition. In a globalizing world, the
meaning of old age is changing across cultures and with in countries and families (Bergeron
2001). According to Mayor (2006), “Some people use their chronological age as a criterion for
their own aging whereas others use such physical symptoms as failing eye-sight or hearing,
tendency to increase fatigue, decline in sexual potency etc.
The traditional sense of duty and obligation of the younger generation towards their older
generation is being eroded. The older generation is caught between the decline in traditional
2. values on one hand and the absence of adequate social security system on the other (Gormal
2003).
Elderly Population in Pakistan:
Currently special rehabilitation facilities do not exist for old persons in Pakistan. Traditionally
adult sons and daughters are obliged to take care of their old parents and virtually all cared for in
the traditional way. Children are expected to look after their parents those who do not are
regarded with disfavor by society. Although extended family system is no more a rule
particularly in the urban areas, at least one of the offspring usually looks after the parents.
Neglect of the elderly is rare. Old people‟s homes are non-existent, almost all live with members
of their family and generally satisfied with their lives. Religious faith is their main source of
strength and their routine activities consist of prayers and other religious obligations.
Nevertheless, the increasing numbers of the elderly pose a challenge including those relating to
their health and consequent disability principally on account of aging problems, senile dementia,
deafness, blindness, and feeling of loneliness, uselessness and boredom. As times passes by the
demand for specific geriatric care would grow. Much remains to be done in the training of more
and better rehabilitation medicine care providers. There is a need for services that can be
integrated into the PHC system and cover a wide range of elderly peoples‟ health problems.
Curative, preventive and rehabilitative care for the disabled elderly should be part of PHC
program.
With the overall strains on familial networks in the face of poverty, the vulnerability of many
elderly people in Pakistan increased in recent years, particularly when their children are
themselves too poor and over-burdened to care for them.
Elderly Population (million)
(60+ years)
Year Total Male Female
Census
1951 1.92 1.03 0.89
1961 2.92 1.68 1.24
3. 1972 4.57 2.63 1.94
1981 5.88 3.40 2.48
1998 7.34 3.99 3.35
Projected Estimates
2013 11.19 5.69 5.50
2030 22.07 11.09 11.09
Table 1: The Elderly Population in Pakistan (past, current & projected)
AGE (YEARS) ALL AREAS URBAN AREAS RURAL AREAS
(Total Population) (Total Population) (Total Population)
ALL AGES 133652121 47739853 85912268
60-64 2671393 910139 1761255
65-69 1852989 638216 1214773
70 & OVER 2611352 852984 1758368
Table 2: Population by Age, Sex and Urban-Rural Residence
PDS 2001 Pakistan
60+ Population & Old Age
Indicator Dependency Burden
60 + Population (in million) 8.1 (2000)
60 + Dependency Burden: 2000 (per one hundred 15-
59 pop.) 10.9
60 + Dependency Burden: 2050 (per one hundred 15-
59 pop.) 19.8
Table 3: Selected Socio-Economic and Health Indicators of Pakistan
Vulnerable elderly are primarily affected when having lost family support or having suffered
injuries and disability. Where the elderly provide for the protection of other dependants, they
often face a double protection dilemma. Older people are often marginalized and frequently fail
to access humanitarian aid and basic services for reasons of poor mobility, social „invisibility‟
4. and the erroneous assumption that „someone‟ is taking care of them already. The challenge will
be to ensure that the elderly will not be overlooked in the reconstruction and rehabilitation
programs.
The Elderly face specific problems in relation to health and medical treatment. They face
problems accessing health facilities due to mobility issues and therefore specific interventions
require health service providers going to them. Chronic health conditions and medical problems
pertaining to the elderly include nutritional deficiencies, chronic diabetes, eye problems and
dental problems. A series of mobile eye camps, dental camps and mobile medical camps will be
encouraged so as to address the specific health problems of the elderly, and also cater to others
requiring such treatment.
The elderly with no adult caretakers (or even with adult caretakers, but who are still neglected)
require support in the reconstruction of their houses in cases where they owned the property.
There may be a substantial number of elderly who do not have their own houses due to property
and/or compensation being taken over by family members, often their own children. In cases
where elderly have no land, shelter or adult support, culturally-sensitive arrangements such as
the Dar-ul- Kifala, can be made available, in which living arrangements for the elderly and the
destitute are provided by the Government. This model is already in operation in NWFP.
Despite intensive extraordinary socio-economic pressures, Pakistani society has stood for high
value, respect and dignity of human life. We in Pakistan, regard old age as a mark of esteem,
wisdom and piety. This could be attributed to the strong ties that exist in the joint family system
nurtured by religious values, dignifying the status of elderly segment of society.
The last century has witnessed a rapid increase in the population of the elderly people in the
developed and industrialized countries. This phenomenon is not restricted to the western world
only, but many countries such as ours are now feeling the impact of this transaction. This
situation could be attributed to a combination of factors such as increase in age, longevity and
decreased death rates due to advancement in the field of medicine, improvement of life
expectancy at birth, and enhancement in the average span of life ( Dubey, A and et al. 2011).
5. Zephyr valley Old Home
Introduction:
The Zephyr valley Home for the Elders, a non-profit organization and charity, is on the leading
edge of being one of the best nursing homes with best practice. It is viewed as a state-of-the-art
nursing home offering an outstanding spectrum of health care services to meet the needs of the
elderly. We are one of the first nursing homes to be accredited by the Ministry of Health as an
Approved Service Provider, providing Step-Down Care that includes accommodation, personal
& health care for elderly suffering or recovering from any sickness, disability or injury.
Name:
This society shall be known as the “Zephyr valley Home for the Elders” hereinafter called the
“Zephyr valley Home”.
Place of Business:
The place of business of the Zephyr valley Home shall be in Gujrat distt. Or such other address
as may subsequently be decided by the Management Board and approved by the Registrar of
Societies. The Zephyr valley Home shall carry out its activities only in places and premises
which have the prior written approval from the relevant authorities, where necessary.
Reason of selecting Gurjat:
Reason in Gujrat city because of family disputes they left their elders at home, high ratio of
people migrate to other cities and on the back only elderly remain here and face lack of family
support.
Scope of organization:
This organization is working on regional level.
Objectives
1. To provide shelter and care to Gujrat citizens and Permanent Residents who are aged
destitute and those in need of nursing or respite care, ambulant, non-ambulant sick, or
otherwise, regardless of their race, sex or religion.
6. 2. To attain the above objectives and provided that nothing is done for commercial reasons,
the Zephyr valley Home shall:
a. Acquire, build or, maintain a Home to accommodate
b. Provide day care to the aged sick, and/or those in need of nursing or respite care,
ambulant and non-ambulant sick, or otherwise, regardless of their race, sex or
religion
c. Undertake any activities as are incidental to the attainment of the above object;
d. Become affiliated to any organization which would further the cause of the
Zephyr valley Home;
e. Raise funds for the above purposes.
Areas of activity:
Following are the area of activities
Ageing
Shelter for elderly
Health care
Social work and advocacy
Awareness campaign
Mission and Purpose:
The mission of the Zephyr valley Home is to provide full range of services to the elders
of Gujrat district with a purpose to maintain & promote the physical, mental and social
well being of elders by enhancing their quality of life and to assist them in remaining
independent and active.
Aims & objectives:
Following are the aims & objectives of Zephyr valley Home.
7. 1. To create love & understanding amongst all the seniors.
2. To facilitate the members for Medical treatment
3. To help & assist the members in the solution of their problems.
4. To arrange outings of members, at recreational places & Gardens.
5. To assess the health, activity and social status of the elderly.
6. To make them busy so that they do not feel loneliness.
Our Services
1. 24-hour Nursing and Medical Care
Zephyr valley Home for the Elders is fully dedicated to meeting the needs of each
resident. Zephyr valley Home addresses the medical and psychological needs of every
resident with a spirit of excellence.
At the Zephyr valley Home, caring for the body, mind and spirit of each individual is
given top priority with round-the-clock nursing care by professionally trained nurses,
assistant nurses, nursing aides and healthcare attendants. Together, they helped to
improve the clinical outcomes for the residents particularly in areas such as infection
control, prevention of pressure sores and end-of-life care. Their expertise and
organizational skills in determining cost and quality of care also provided the Home with
a competitive advantage in the healthcare marketplace.
A general practitioner visits the Home 3 times a week, together with regular visits from
geriatricians, psycho geriatricians and other medical specialists who conduct assessments
and consultations.
With a team that is equipped and ready to cover all aspects of medical care, residents are
guaranteed to receive the highest level of support 24-hours a day, 7 days a week.
2. Short-term and Long-term Rehabilitation
With full-time physiotherapists and occupational therapists on-site, as well as a clinically
equipped gymnasium, the Zephyr valley Home offers short-term and long-term
rehabilitation to residents.
o Short-term rehabilitation programs help residents recovering from stroke or
fracture resume an independent lifestyle in the community. This program is
8. designed to focus on the restoration of functionality through a combination of
physical, occupational and speech therapy.
o For residents with a functional impairment, chronic ailment or dementia, long-
term rehabilitation is often recommended to help prevent further deterioration of
their condition as well as to improve their level of comfort. Treatment can
involve a combination of person-centered care by our team of nursing staff,
coupled with physiotherapy, occupational therapy, speech therapy, dietitian and
pharmacist.
3. Physiotherapy and Occupational Therapy
A key focus at the Zephyr valley Home is the physical and mental wellbeing of each
individual resident. The Home‟s full-time rehabilitation therapy staffs are dedicated to
strengthening residents‟ physical bodies as well as re-establishing their sense of
independence.
Physiotherapists and occupational therapists work hand-in-hand with the Zephyr valley
Home‟s medical team and other clinical expertise to design customized therapeutic
programs that help restore residents‟ functionality and develop confidence.While
programs may differ from resident to resident depending on their needs and abilities, their
goals remain the same:
o Increase, restore or maintain range of motion, physical strength, flexibility,
coordination, balance and endurance
o Promote independence with the improvement of walking skills
o Increase overall fitness through exercise programs
o Improve sensation, reduce pain and discomfort
We have achieved much success from recognizing that physical therapy is a “hands-on” process.
Our specialists work with residents on a one-on-one basis because this helps to bring out the best
in each resident‟s capabilities
9. 4. Resident Social Life
The Zephyr valley Home organizes arts & crafts activities, cooking, concerts and
monthly outings to local hawker centers, markets and shopping malls for residents to
learn, grow, express themselves and just have fun. These social activities help to
stimulate the intellect, rebuild strength and raise the spirits of our residents
5. Social Work and Advocacy
The Home has social and welfare workers on-hand to help residents adjust to communal
living. Offering counsel, guidance and support, our social and welfare workers maintain
ongoing relationships with both residents and their families to ensure that their concerns
are being met and their problems addressed.
With an interdisciplinary team that includes social work, the Home makes sure that
residents‟ rights and needs are attended to at all levels.
Staff at the Zephyr valley Home takes resident advocacy very seriously. The level of care
that a resident requires is always taken into consideration first before our staff work as a
team to custom-design treatment programmes for each resident.
6. Management and Care of Dementia
Contrary to common belief, people suffering from dementia are able to live at home.
Those admitted to the Zephyr valley Home generally have more diverse and complex
needs in addition to dementia.
Given the dynamic environment at the Zephyr valley Home (with the differing and
changing needs of residents), our highly skilled staff are more than capable of coping
under high-stress situations with great understanding, insight, compassion and the
commitment to treat each and every resident as a valued individual.
o Pets Corner...
It‟s a proven fact that pets offer constant interest, stimulus and help satisfy the
need for contact. Our Pets Corner offers pet therapy by creating a homelike
environment and provides enjoyment to both residents and their visitors.
o Yesteryear Room...
Our Yesteryear Room provides reminiscence therapy for residents. This form
10. of therapy acts is known to be effective in enhancing self-esteem, reducing
isolation and providing comfort and familiarity for the elderly. Especially for
residents with dementia, reminiscence therapy helps stimulate communication
and interaction with others by encouraging them to recollect things and events
from the past
7. Scheduled Respite Care
In addition to the long-term care offered by the Zephyr valley Home, scheduled respite
care is available on a short-term basis. This service offers nursing care and lodging, and
is ideal for families looking for a temporary arrangement for their loved ones in need of
medical and nursing care.
8. Training & Education
Zephyr valley Home believes in providing quality holistic care to our residents. To
achieve this requires growing the number of competent and knowledgeable nurses and
care assistants in the Home. We therefore place a great emphasis on continuing
education, on-the-job training, and clinical based research.
To provide holistic care requires a multidisciplinary and interdisciplinary approach,
integrating inputs from program to management to staff activities. Hence Zephyr valley
Home provides in-service training in multiple disciplines, and also constantly reviews
corporate-wide processes including management structures, staff activities and resident
outcomes to ensure high quality and standard of care and services.
All of these efforts are aligned with our efforts to improve our knowledge-based and
evidence-based practices in long-term care.
9. Elderly rehabilitative day activities
Elderly rehabilitative day activities support living at home and coping at home despite
illness and paramnesia. Day activities offer also social intercommunication and
stimulating participation. These activities include breakfast, lunch, coffee and
transportation at need. You can join day activities through your local social and contact
work units of elderly services.
11. 10. Senior Day Care Centers
Senior Day Care Centers provide facility-based programs for frail elderly who are able to
reside at home and travel to other locales if supervision is available. Services are
designed to meet the clients' needs by personnel trained to work with physically-
dependent seniors. Some centers accept persons with dementia.
11. Old is Gold Studio
A very important objective of our Zephyr home is the awareness campaign using
electronic media , radio and television in order to set standards regarding aging
population and their problems and issues and techniques to get rid of those issues. The
most important part is that the elders admitted in Zephyr home are itself promoted and
polished to perform and act in different departments of the studio, in this way not only we
can provide them with savings of their own but also this activity keeps them busy all the
time and they don‟t have time to think about their nightmares.
12. References:
1. Session Session-I “Addressing Coverage Gaps in Pension Schemes in Pakistan”. Panelist
Sabur Ghayur Chairman, Policy Planning Cell Labour and Manpower Division
Islamabad. EOBI/WBI Key Challenges in Pension Policy in Pakistan Pension
Pakistan””99--10 May 2007, Islamabad10 Islamabad. Retrieved from
http://info.worldbank.org/etools/docs/library/241484/Session%252001May9Sabur%252
0Ghayur.pdf
2. Pakistan demographic survey – 2001. Federal Bureau of Statistics. Retrieved from
http://www.statpak.gov.pk/depts/fbs/statistics/pds2001/pds2001.html
3. Source: Different sources were used including the World Bank (2000, 2001); Human
Development Centre (1997, 2002); ADB (2001); Planning Commission of India (2002);
UN‟s Population Prospects (2002 Revision).
4. Azam, H., Ahmad N and Ahmad B. 2012. Determinants of Work Responsibilities of
Pensioners in Pakistan: A Case Study of District Khushab. International Journal of
Business and Behavioral Sciences: 2(8).
5. Gormal K 2003. Aged in India. Mumbai: Tiss Publishers.
6. Mayor R 2006. Significance of grandparents: Perceptions of young adult grandchildren.
Gerontologist, 16(1):137-140.
7. Bergeron LR 2001. An elderly abuse case study: Case gives stress or domestic violence.
Journal of Gerontogical Social Work, 34(3): 47-63.
8. Gowri GB 2003. Attitudes towards old age and ageing as shown by humor.
Gerontologist, 17(2): 220-226.
9. Dubey, A., Bhasin S., Gupta N., and Sharma N. 2011. A Study of Elderly Living in Old
Age Home and Within Family Set-up in Jammu. Stud Home Com Sci, 5(2): 93-98