Old Age Unit VII

Old Age
Old Age
• Old age comprises "the later part of life; the period of life after
youth and middle age , usually with reference to deterioration".
• At what age old age begins cannot be universally defined because
it differs according to the context.
• The United Nations has agreed that 65+ years may be usually
denoted as old age and this is the first attempt at an international
definition of old age.
• However, for its study of old age in Africa, the
World Health Organization (WHO) set 55 as the beginning of old
age.
• At the same time, the WHO recognized that the developing world
often defines old age, not by years, but by new roles, loss of
previous roles, or inability to make active contributions to society.
Old Age
• Old age starts after 60 years and age of retirement.
• Successful ageing is defined not by longevity alone but also by
sufficient well-being in multiple domains-socially, physically and
mentally.
• The three components for successful ageing are avoiding disease,
engagement with life and maintaining high physical and cognitive
functions.
• Aging can be associated with changes in lifestyle and health that
may affect the types of foods eaten and the nutritional status.
• Loneliness, boredom, depression and worrying about the future
can lead some to neglect of food intake.
Old Age
• Old is not a disease but a biological process that no one can avoid.
• A little care and caution will prevent or delay disabilities, with proper
care every one can enjoy long run healthy aging.
• It is true that a person can feel and behave very old age at 45, another
one at age 85 may lead an active life enjoying good health.
• Old age is a period of decline in physical strength and social
participation.
• As age advance several chronic disease effect their health.
• Many of these like obesity, hypertension and diabetes are diet related
and enhance can be controlled and even prevented by modifying their
diet.
• The problems of old age stem from disability, diseases, dependence and
death.
Old Age
Developmental Tasks needed for successful Ageing:
1. Adjusting to declining health and physical strength.
2. Adjusting to retirement and reduce income
3. Adjusting to death of a spouse.
4. Establish associations with others in the same age.
5. Maintaining a satisfactory living arrangement.
6. Adapting to changes in social roles.
Old Age
A. Physical Changes
• Ageing is a natural process. Everyone must undergo this phase of
life at his or her own time and pace.
• In the broader sense, ageing reflects all the changes taking place
over the course of life.
• As strength declines , the various organs and organ systems slow
down.
• Diabetes, heart conditions, osteoporosis and such diseases arc
common during old age.
• Disabilities in walking, seeing, hearing etc restrict the person in
several ways.
• These disabilities make the person dependent on others.
• According to World Health Organization, ageing is a course of
biological reality which starts at conception and ends with death.
Old Age
A. Physical Changes
• There is a gradual but steady loss of cells and reduction in
metabolic processes which means the performance
capacity of his systems goes on steadily deteriorating.
• The decline varies in different systems in different
persons. However, in general, the body mass becomes
leaner.
• By 65 – 70 years of age, the kidneys and lungs lose about
10 percent of their weight.
• This loss goes up to 18 percent in case of liver, while the
skeletal muscles diminish by approximately 40 percent.
And bone mass loses as much as 25 percent.
Old Age
A. Physical Changes
• All these creeping declines results in overall reduction in the
body's reserves.
• An important features of this aging processes is the reduced rate
of blood flow through the kidneys, to the extent 65 percent.
• The blood sugar level takes longer time to return to the normal
level.
• But the major role player in aging is the gastrointestinal system.
• The secretion of digestive juices goes down.
• The motility of the intestinal tract decreases and absorption and
utilization of the nutrients also decreases.
Old Age
B. Psychological Changes :
• An old person is often isolated. The disease and disabilities
produce a strong feeling of inadequacy and the dependence
makes the person feel worse.
• They arc given to depression and moodiness.
• Death of the spouse plunges the person into despair making
him/her feel totally at a loss.
• Memory fails the old person which creates further problems.
• Fear of death can be a dominant emotion.
• Worries about whether he/she would be invalid, a burden to
others is very common
Old Age
• Most elderly people seems to be most vulnerable to
psychological dysfunction when they experience change.
• Affective function refers to the mood, emotions (such as
happiness, sadness, fear, pain, anger, and confusion).
• Cognitive function refers to memory, learning, and intelligence.
• Cognitive and affective functioning affects the person’s self-
esteem.
1. Affective Function
• It is influenced by the way an individual views the world and self.
• A positive view of self and surrounding environment promotes
positive expression of mood and emotions
Old Age
a. Self – esteem
• It is the way a person views himself/herself.
• A positive view of self promotes health and enables the person
to cope better with the changes and challenges of growing older.
Following factors contribute to decreased self-esteem
• Age related changes.
• losses that occur with aging
• Chronic diseases.
• Increased dependency .
• Function impairment.
• Lack of control over the person environment
Old Age
b. Personality
• The basic personality does not change as a result of aging
process.
• The personality will be consistent with that of earlier years.
c. Depression
• Depression occurs 16-65% of elders living in the
community.
• Depression including: sleep disturbance, lake of interest,
feelings of guilt, lack of energy, decreased concentration
and, loss of appetite.
• Losses can lead to depression.
Old Age
2. Cognitive Function
Intelligent, learning, attention and memory are all related to cognitive
functioning and how well the mind is able to reason and make
sound judgments.
a. Intelligent
• Intelligent is a mental alertness and includes the ability to learn new
material, make wise decisions, and deal with stressful situation.
• Intelligent does not become less with age.
• IQ test performance of older adults may be hindered because of
sensory deficits or the stress of being tested. These factors must be
considered when assessing
Old Age
B. Psychological Changes:
b. Memory
• Recent memory is defined as a recall of items learned more than a
few minutes earlier, e.g. the day's new events, what was eaten for
breakfast, the date. Recent memory generally declines with age.
• Remote memory is defined as a recall of items learned many years
earlier, e.g. the dates of wars, names of presidents, remote memory
does not experience significant change with age.
c. Learning
• Learning is the acquisition of new knowledge or skills.
• The ability of the mind to learn and retain new information remains
unaltered, particularly when mind is stimulated through regular
use.
• The ability to solve complex problems decline with age.
• Hearing and visual deficits related to aging process can affect
learning.
Old Age
d. Attention Span
• There is decrease in vigilance performance.
• Vigilance performance is the ability to retain
attention longer than 45 minutes.
• The elderly is more liable to distract (divert)
attention by irrelevant information and stimuli.
• Deficits in attention may affect learning and
memory.
Old Age
Psychological Problems:
Poor adjustment to role changes Loneliness
Poor adjustment to lifestyle changes Isolation
Family relationship problems Problems with sexually
Grief Elderly abuse

Low self-esteem Withdrawing and having a negative
Anxiety and depression attitude toward life in general
Aggressive behavior
Old Age
Psychological Problems:
• Mortality awareness brings the psychological
problems in ageing people.
• Widowhood, death of friends, and the recognition
of declining functions make older person more
aware of the reality of their own death.
• Attitudes about death vary with aging.
• The elderly tend to think and talk about death, but
they find the prospect of death less frightening.
Old Age
B. Social Changes :
• Social and emotional experiences change with age
• Older people retire often from work.
• Their busy life suddenly comes to a halt.
• Re-employment possibilities may not be bright enough.
• Thus, the old person finds too much time at hand, with
too little work and reduced mobility very frustrating.
• Redirecting and remodeling the entire life style with
meaningful activities become necessary.
Old Age
B. Social Changes :
• The peer group members are no longer accessible due to various
reasons.
• The social status of a widow or widower is not a pleasant one
either.
• Dependent on others for even small things, mobility, money and
moorings, the social life of the old person shrinks drastically.
• Social partners that are meaningful and important are preserved,
more peripheral social ties are discarded , and anger and distress
are experienced less frequently.
• Positive affect remains highly stable, only decreasing in some
studies among the oldest old
Old Age
B. Social Changes :
• As an individual he/she needs to take personal
responsibility for self that is a milestone.
• The developmental tasks become the individual life
and existence, rather than the others in the social
circle.
• Happiness in old age is centered around children and
their welfare.
• Simple events and memories, shared love and concern,
provide feelings of satisfaction to the old person.
Old Age
B. Social Changes :
1. Retirement
• A change in work role comes with retirement.
• It changes the way time is managed and daily activities are carried out.
• Retirement alters identity, status, financial problem, lack of self-
satisfaction and self-esteem and sometimes friendships.
2. Widowhood
• A common event that alters family life for the aged is the death of a
spouse.
• The spousal role composed of many sub roles, such as companion,
sexual partner, confidante, cook, house-keeping, and care provider.
• Loss of spouse is a highly stressful experience. Death of a spouse affects
more women than men because most older men will marry again
Old Age
B. Social Changes :
3. Loneliness
• Loneliness is the feeling of emotional isolation, being locked inside oneself
and unable to obtain the warmth and comfort from others.
• Any loss that creates a deficit in intimacy and inner personal relationships
can lead to loneliness.
4. Roles change
• Numerous role changes occur with the aging process, but the transitions
expected by most elders are related to the work role and the role of spouse
or partner.
5. Multiple Losses
• Aging is associated with major physical, psychological and sociologic
losses as well as a reduced ability to adapt and compensate for stressors.
Old Age
B. Social Changes :
Some example of losses:
• Loss of job (retirement)
• Loss of status
• Change role
• Loss related to normal age-related changes
• Decreased income
• Increase expenditure on medical services
• Loss of significant person
• Loss of housing
• Decreased the ability to adapt and compensate for stressor
• Limitations impose as a result of multiple chronic diseases
Characteristics of old age
1. Old age is a period of decline
• Decline comes partly from physical and partly from
psychological factors.
• There is change in body cells due to the aging
process.
• Unfavorable attitude towards one self and life in
general can lead to decline or become depressed and
disorganized.
• Motivation plays a very important role to decrease
decline.
2. Individual Differences
• There are individual differences in the effects of
aging.
• People age differently because they have different
hereditary endowment, different socio economic and
educational backgrounds and different patterns of
living.
• The general rule is physical aging precedes mental
aging.
3. Old Age :Judging criteria
• Old age is judged by different criteria - age is judged in
terms of physical appearance and activities.
• Children and young people judge the old person based on
their physical appearance
• One who has white hair is labeled as old.
• Old people can not work efficiently
• There are many who try to cover up their aging symptoms
to create illusion that they are not yet old.
4. There are many stereotypes of old people:
• Some age-related stereotypes are positive,
such as the kindly grandparent or wise
matriarch.
• However, in Western culture especially, most
of these stereotypes are negative.
• People tend to feel younger as they get older.
5. Old age poor adjustment:
• Because of the unfavorable social attitudes towards
the elderly that are reflected in the way the social
group treat them, it is not surprising that many
elderly people develop unfavorable self-concepts.
• These tend to be expressed in mal-adjusting behavior
of different degree of severity.
• Financial and physical losses may have affect their
psychological condition.
• Family and friends are important for their life.
5. Old age: social attitudes towards them:
• Social attitudes were the every society evaluate the old person
who they are and what is the role they have.
• Attitudes towards aging are influenced by expected life span,
economic conditions, social expectation, media, arts, and
literature of the time.
• Ageist attitudes may be excessively positive or negative
depending on one’s tendency to stereotype individual based on
their age.
• Ageing are senior citizen in our country and the government
recognized them special facility in public transportation, health
and others.
6. Old age: Minority group status:
• Old peoples have less control or power over
their lives.
• They are physically and mentally weak and
dominant by other group.
• They have less role of family and society
• Ageing people do not get opportunity for the
further job or any work.
7. Old age: Role changes:
• When the old age begins, they are not able to
following previous activities like walking the
outside or going to particular club or
interacting with senior citizen.
• They remain and taking rest at home or bed,
these poor role change influences their aging
process.
7. Old age: Extensive desire for Rejuvenation:
• Rejuvenation is the reversal of aging and thus requires a
different strategy, namely repair of the damage that is
associated with aging or replacement of damaged tissue with
new tissue.
• Rejuvenation can be a means of life extension, but most life
extension strategies do not involve rejuvenation.
• Every people want to be young forever, in aging they want to
run young and they use different types of medicine and other
process.
• Rejuvenation depends on their fitness, nutrition, active lifestyle,
heredity and health condition.
Situation and problems of senior citizens and
intergenerational conflicts with senior citizens in
Nepal
• The senior citizens Act 2006, Nepal also defines the
senior citizens as ‘people who are 60 years and above”
• The retirement age for military in Nepal is 45 to 48 years
for lower class for general government service 58 years
and for University teachers and the judiciary services 63
years.
• In Nepal people above 60, years are considered as elderly.
• According to the census of 2011, 8.1 percent among the
total population was covered by the people above the age
of 60 years that was only 6.5 percent in 2001.
Nepal
• The elderly population in Nepal is growing
steadily at the rate of 3.77% per year
• Recent demographic and socioeconomic
changes such as the rapid increase of the older
population and the out migration of children
from rural areas have led to changes in the
traditional care system.
• One example is a rise in the number of elderly
living in old age homes.
Nepal
Population of senior Citizen in Nepal
• 1991 1071234
• 2001 1504311
• 2011 2154450 (8.13%)
• 2020 2850000 (Assumption)
• 2121 2950000(Assumption)
Nepal
Old age home in Nepal
• There are 141 old age home in 64 district
except Udayapur, Khotang, Saptari, Manang,
Pyuthan, Kapilvastu, Dolpa, Humla, Rukum
Paschim, Baitadi, Doti in Nepal
• In 53 district there are 62 old age homes, 30
day care centre, 6 take care centre and 4
kalpabas
Nepal
Social Security allowances for senior citizen
• Social security act has been implemented in 2075
Ashwin, 2.
• Dalit Community: >60 years- 2000/month
• Other community: >70 years – 3000/month
• Dalit community : > 70 years – 3000/month
• Female any community: >70 years – 3000/ month
Nepal
Existing Issues and problem related this area
• Despite various activities conducted in the favor of senior citizens,
efforts are not satisfactory to comply with existing national plan and
policies, global and regional resolutions and commitments. Following
challenges and problems are realized in this area of work;
• Lack of adequate resources to address the demand of increasing
population of senior citizens
• Transition to unitary to nuclear family in high poverty incidence
scenario of the society.
• Increasing psycho-social problem to senior citizens due to lack of
adequate service providers to address health, care, security and
rehabilitation.
• Inability to attract private sector in this area of work.
Nepal
Existing Issues and problem related this area
• Lack of appropriate institutional mechanism and co-ordination for
program implementation.
• Non-existence of governmental and constitutional commission for
perspective plan, policy and regulations for effective
implementation of senior citizens care programs.
• Lack of appropriate program for utilizing experience, skills and
knowledge of senior citizens
• Less development of positive attitudes in the communities
towards senior citizens.
• Inadequate institutional and sustainable development of
appropriate old care centres, day care centres and clubs.
Nepal
Challenges and health problems
• The growing number of elderly population is becoming one
of the great social challenges over the past few years
• New clear family
• Urbanization
• Modernization
• Urbanization
• Social strains like poverty and economic insecurity are
eroding the family support system leaving old people to take
care themselves
• They are less seen as a burden on family’s scare sources
Intergenerational conflicts with senior citizens in
Nepal
• In societies with deeply-rooted culture and

traditions, the older generation may be reluctant to
accept newer thoughts and practices.
• They may be less inclined to ideas of the younger
generation which in turn may unleash generational
conflicts.
• For the younger generation, the thought of rejecting
older values and securing a better future is enticing.
Intergenerational conflicts with senior citizens in
Nepal
Causes of Intergenerational conflict with senior

citizen:
• Social differences
• Educational differences
• Cultural differences
• Lack of awareness in senior citizen
• Traditional behavior followed by senior citizen
• Emotional attitude
• Lack of moral education in young people
Senior Citizens: Managing Old Age – Preparation
and coping strategies to about in family and society
Coping:
• Coping is the process of contending with life difficulties in an
effort to overcome or work through them.
• Coping was pictured by Briklend & Naving (2009), from two
angles first as a personality trait and second as a process
changing in relation to current situation.
• Coping definition is multi- dimensional depending on the
situation at hand, possilibility to adopt and the available
resources.
• It could be response to medical, biological or psychological
stressors regarding problem solving and emotion focused .
Factors that influence coping in old age:

1. Religion and spirituality:
• Widely recognized as major coping resources that have a
positive effect on many aspects of psychological function
for older adults
2. Cultural considerations:
• Definition of mental health and mental illness
• Belief about the causes of mental health and illness
• Expression of symptoms or clinical manifestation of
mental health and illness
Goal of coping strategies:

• To strength/ maintain family resources
• Reduce the source of stress/negative emotions
• Achieve a balance in family functioning
Factors influencing coping strategies:

• The personality characteristics of the family
members
• Financial status
• Educational level
• Problem solving skills
Coping strategies:
1. Retirement
• Develop new skills
• Use time of hobbies and personal pursuits
• Become involved with meaningful volunteers activities
2. Death of friends
• Allow yourself to grieve appropriately
• Establish new relationships
• Renew old friendships
Coping strategies:
3. Ageist stereotypes
• Develop a firm self identity
• Challenge the myths
• Question any behaviors that are based on age
determined expectations
4. Relocation from family homestead
• Appropriate the relief from the responsibilities of
home ownership
Coping strategies:
5. Change in cognitive skills
• Take advantages of education opportunities
• Enroll in classes
• Keep mentally stimulated
• Join a discussion group
6. Declining physical health
• Maintain good health practices (Nutrition, exercise,
rest)
Risk factors that may lead to poor coping:

• Poor physical health
• Weak social supports
• Lack of economic resources
• Narrow range of coping skills
• The occurrence of unanticipated events
• The occurrence of several major life events in a
short duration
Government plan and policies for welfare of senior
citizen in Nepal
• The Nepalese council of Ministers on 2061 -05-03 BS

adopted a guidelines entiled Jestha Nagarik
Swasthopachar Sewa Karyakram Karyanyowan
Nirdeshika 2061 BS (Senior Citizens Health Facilities
Program Implementation Guideline, 2061BS) which
attempts to provide medical facilities to the old age people
• Following the “Senior Citizen Health Facilities Program
Implementation Guideline, 2061 BS”, the poverty affected
elderly people are provided free medicine and treatment up
to NRs. 2000 at a time in all 75 districts from the fund.
citizen in Nepal
• The Labour Act, 1992, fixes minimum wage and

provides for social security of workers in the formal
sector
• The Civil Service Act 1992 and Regulations 1994,
have provisions related to social protection of
government employees.
• The Local Self-Governance Act 1999, provides for
protection and development of orphan children,
helpless women, the elderly and people with disability
citizen in Nepal
• The Nepal Health Service Act, 1997, outlines various

social security and health schemes for senior citizens
• National Human Right Commission NHRC(2011) state
that respects for elders and protection for weaker are
the two basic human values that all societies have been
promoting since the beginning of human civilization.
• Discuss the social security and protection of Senior
Citizen Act 2006 was landmark from a legal point of
view, but its implementation is problematic
citizen in Nepal
Medical Treatment of deprived Citizens(Bipanna Nagarik

Kosh), Mohp
• It was started after Janaandolan 2062 BS. With the country
slowly recovering the form decade long armed conflict, this
kosh was established to provide some financial relief to people
from difficult and expensive diseases
• Cardiovascular disease, cancer, renal failure, Alzheimer’s
disease, Parkinson’s disease, Head and spinal injury, Sickle
cell anemia and stroke are covered under this program.
citizen in Nepal
Social Security Services:

• The government was provided Old Age Allowance of Rs. 500
per month to people age 70 and above. The government
provides Rs. 500 per month for widow 60+.
• Now beginning fiscal year 74/75, the government started
distributing Rs. 2000 in monthly allowances to citizens above
70 who are not pensioners citizens. The age bar is 60 for old
people in Karnali and the dalits
citizen in Nepal
Health insurance policy 2074 (2017):

• It is a social protection program of the Government of Nepal that
targets to support its citizens to access quality health care
services without placing a financial burden on them.
• Mandatory enrollment for formal and informal sectors.
Contribution:
• NPR 2500/5 members/ year( NPR 425 for every addition
member)
Benefit Package:
• NPR 50000/ 5 members/year. (NPR 10,000 per additional
member but a maximum ceiling of 100000 per family.)
Role of NGO’s, INGO’s and stake holders for
better life of Senior Citizen
• There is an Old Age Home in the premises of temple Pashupati Nath
(Pashupati Bridrashram) for the destitute elders.
• Likewise in Devghat of Tanahun , Sitapaila of Kaski, dhangadi,Kailali
and many other places in different communities have a common interest
over the care of elderly citizens especially around urban areas being
easy access of donors and many more in recent days.
• Ministry of Women, Children and Social Welfare operates the old-age
home that has the capacity for only 230 elderly people.
• This is the only one shelter for elderly people run by the government
which was established in 1976 as the first residential facility for elders.
• There are about 82 organizations registered with the government spread
all over Nepal.
• These organizations vary in their organizational status (government, private,
NGO, CBO, personal charity), capacity, facilities, and the services they
provide. Most of them are charity organizations.
• About1,500 elders are living in these old-age homes at present.
• These private organizations are providing services to elderly out of the
individual’s initiatives.
• The services are determined with the consent of the individual generosity.
• The services and care, virtually, do not include aspects that are essential to
cater elderly in these Homes.
• Despite these initiatives, the Government does not have any official records
on how many old age destitute people are taking shelter in these Old Age
Homes (Briddhashrams).
• Source: Adhikari S. Health, Nutrition and Care for Senior Citizens of.....
JHAS, 2013, Vol. 3, No. 1 P 73-75
• There are 141 old age home in 64 district
except Udayapur, Khotang, Saptari, Manang,
Pyuthan, Kapilvastu, Dolpa, Humla, Rukum
Paschim, Baitadi, Doti in Nepal
• In 53 district there are 62 old age homes, 30
day care centre, 6 take care centre and 4
kalpabas
Ageing Nepal
• Ageing Nepal is a non-profit NGO established in 2011 by a group of Nepali
social workers committed to helping older people in the country. It does
consultancy to develop research and workshops, and help guide policy on ageing.
• It trains health workers, care givers and other groups on gerontology and
geriatrics, and works with academic institutions to promote research and teaching
on ageing issues.
• Ageing Nepal campaigns on older people’s rights, and takes proactive measures
to fight abuse and exploitation. It builds awareness on issues affecting older
people through the media, and gets involved in Age Demands Action.
• Ageing Nepal became a HelpAge global network member in 2017.
Contact information
• House #340, Ramchandra Marg, Battisputali, Kathmandu
Email: ageingnep@gmail.comWebsite: ageingnepal.org
National Senior Citizen Federation (NASCIF)
• The National Senior Citizen Federation (NASCIF) is an NGO established in 2011 to
protect the rights, welfare and best interests of older people in Nepal. It has established
older people’s associations for older people across all the country.
• NASCIF was founded to develop an effective approach to meet the challenges and
opportunities of Nepal’s growing number of older people. It acts as a national network
for organisations working to improve and uphold the rights of senior citizens in Nepal.
• NASCIF is involved in campaigning and awareness raising on older people’s rights, and
conducts advocacy work and research on ageing. It also develops educational materials
on ageing, runs training courses, coordinates health services, and facilitates the setting up
of day care centres throughout Nepal.
• NASCIF became a HelpAge global network member in 2017.
Contact information
• Jagatnarayan Mandir, Shankhamul Lalitpur
Nepal G.P.O. Box 2530Phone: 977-15260347
E-mail: nascifnp@gmail.comwebsite: www.nascif.org.np
Nepal Participatory Action Network (NEPAN)
• Founded in 1995, the Nepal Participatory Action Network (NEPAN) is an association of
individuals and institutions promoting the participation and empowerment of Nepalese
in development across Nepal. It supports people from marginalised groups, especially
older people, women, children and disabled people.
• NEPAN’s research focuses on ageing, influencing policymaking, developing healthcare
services, promoting positive ageing and providing training to partner organisations. It
also runs socioeconomic activities to help older people generate secure and reliable
incomes.
• NEPAN is made up of almost 300 individual and institutional members, and works with
government ministries, international NGOs and other national organisations. It became
a HelpAge global network member in 2017.
Contact information
• Dobhan Tole, Sahayogi Nagar, Janata Sadak,Koteshwor-32, Kathmandu, Nepal
Email: nepan@nepan.org.np Website: nepan.org.np
Panchawati Old Age Homes
• Nepal is a home to about 3 million senior citizens. Traditionally, they love living
with their children by the last moment of their lives. But today, the traditional
value-system of our people has been overtaken and their socioeconomic
priorities also have been shifted. Realizing the need of comfortable and
luxurious senior living, we have established PANCHAWOTI HOME.
• PANCHAWOTI is a paid retirement home initiated by a team of professionals in
order to offer senior citizens the opportunity to lead an independent life of
dignity and respect in the pleasing company of likeminded individuals. We
welcome senior citizens for the short and long term stay at PANCHAWOTI.
Contact information
• Changunarayan Muncipality Ward No 9, Tathali, Bhaktapur
• Contact No: 015091517
Panchawati Old Age Homes (Fee Structure)
Monthly Fee: Starts form NRs. 30,000 per/month
Security Deposit (Refundable): NRs. 1 Lakh
Panchawati Old Age Homes (Facility)
1 .Room:
• You can choose your room from the followings:
• Single Room
• Shared Room
• A single room will be used by a single person whereas two people will share the shared room. Both the
rooms have :
– Comfortable bed/ Attached toilet /bathroom Cupboard/ Sofa/TV/ Emergency Call Point/Hot and cold water
supply
– Tea and coffee maker etc.
2. Personal care:
• We offer the best personal care services to our active and assisted residents with love, care and respect.
3 .Hygienic Food:
• We have a well equipped kitchen. Weekly menus are set in consultation with the dieticians. Well
balanced and nutritious food is served in a buffet style in the dining area. If required, food can be served
at the tables and even in the room. All the vegetarian and non vegetarian food items are prepared, kept
and served separately.
4. Housekeeping:
• We have trained housekeeping staff. They clean your room and toilet, make your bed. They maintain
cleanliness of all the common areas as well.
Panchawati Old Age Homes (Eligibility)
There are a few basic criterions for admission.
• 1. Age:
• The minimum age required to become eligible resident of PANCHAWOTI is 60 years
for dependent and 65 years for independent .
• 2. Medical Fitness:
• The resident should be mentally fit. He/she should not be suffering from Dementia,
Alzheimer disease or any type of psychiatric disorder.
• The resident should not be suffering from any infectious or transferable disease.
• To become a resident, he/she need to go through the medical screening by the board
assigned.
• 3. Nationality:
• People of all the nationalities are welcome at PANCHAWOTI. The following relevant
documents are required:
• Citizenship certificate for the Nepali citizen.
• A copy of the passport with valid visa for the foreign national.
The Hope Hermitage
• The Hope Hermitage (THH) is a Senior Citizens,
Home, Club & Day Care Center established with the
commitment to build a fulfilling, motivational age
friendly social secured life for the elderly people.
• We provide care and support to all aged elders
through our special ward and trained professionals.
However, we have special care for elders’ suffering
from Alzheimer’s and related dementia.
The Hope Hermitage
• The THH believes that the contribution of Senior Citizens
is invaluable to the betterment of the society we live in.
• Life in THH is very homely, full of joy with immense
care facilities.
• All health related/medical services will be provided by an
adjoining care from Chirayu Hospital, Nepal Cardio
Clinic and Specialist doctors and Professors on call.
• The THH understands the significance of hygiene, which
is reflected in its services. We maintain a very regular
routine in order to promote good hygienic condition.
The Hope Hermitage
• The Hope Hermitage focuses on the convenience of the family
members who have to care their elderly parents also need time for
their regular job. Pick up and drop off facility is also provided.
• Hope Hermitage Elderly Care was founded by Ms. Pramila
Bajracharya Thapa in 2017 to meet the growing need for elderly
care and services in Nepal. Originally a Home Care provider with
a special focus on Alzheimer’s and Related Dementia Care,
assisted living home, palliative care, etc. Hope hermitage offers
services in Kathmandu.
The Hope Hermitage
• HHEC is an elderly care home providing assistance with an
assurance of living in dignity where facilities and comforts are
ensured aligned to physical, mental and psychological well-being of
the elderly, after invested many years of your time in brining your
kids up and gain a social status and now it is a second home that you
will be surrounded by warmth, comfort and fully relieved of daily
chores to enable enjoyment of living and socializing with likeminded
residents, enjoying old age and adding years to life in good health.
HHEC delivers necessary care and support through our trained

expertise and professionals. We believe in taking pride in being the
best by providing invaluable contribution towards our elderly care.
Life at HHEC is very homely, joyful and immense care facilities.
The Hope Hermitage
Mission
• Facilitate, care, support and motivate Senior Citizens to live a healthy and
fulfilling social life
Vision
• A Nepali society that has positive attitude towards senior citizens where the
elderly people can have better environment to live a dignified life
Value
• We live by the following values:
Quality: We are committed to excellence in the service and care we

provide
Respect: We promote a culture for creating and maintaining mutual respect
Health Home Care Nepal
Residential care
• Residential care packaged with lodging, food, geriatric
nursing care under the guidance of a doctor and
geriatric counseling will be availed for the elderly
people with or without chronic medical conditions that
require stabilization, and/or are dependent on oxygen,
and also for those who are being dependent for daily
life in the absence of family
Health Home Care Nepal
Objectives
• The objective of our old aged home is to provide
residential care services in Nepal, Targeting minor
geriatric health and social problems focusing on
nursing care for elderly people.
• Provide recreational facilities for social and mental
peace for Elderly people, create home environment
responding daily needs that makes comfortable for old
aged people in Nepal.
Health Home Care
Beneficiaries
• The beneficiaries of this old age home in Nepal
are medically dependent as well as Non
dependent Elderly people above 60 years from all
levels of society who need social and medical
care that could be handled by trained nurses
under continuous supervision of Medical doctor
Health Home Care
Strategy
• In relation to target market, this care home
though it is private it is targeted to provide social
service for the noble cause in this universe.
• Strategy is to expand the service in parallel to
occupy the elderly people from affordable as well
as non affordable groups throughout Nepal.
Health Home Care
Purposes
• Health care delivery system in Nepal has been improving &
more population now has access mainly in primary health care.
• People’s life expectancy has been increased substantially
compared to the past due to advancement, availability &
information dissemination of medical & health care services.
• However, specific health services targeted to specific groups is
still lacking.
• Traditionally it’s been the immediate family members who have
been the primary care givers especially for their older relatives.
Health Home Care
Purposes
• There has been a distinct change in our society in terms of
the mass movement of the youth to foreign countries in
search of better job opportunities.
• This has led to households full of older people –without the
support of their younger relatives.
• While major health issues have to be treated in the hospital,
there are so many relatively minor health problems that can
be addressed by home services.
• This project has been initiated recognizing the need for
such specialized health care.
Health Home Care
• Being a medical graduate, after completing a master’s
degree from Australia, my intention was to work in the
most prioritized area.
• Hence I got a chance to work for HIV/AIDS and TB for six
years.
• During that period, I came across the problems that old-
aged people were facing. I came to know about the global
scenario related to population aging.
• Meanwhile, in my family, I and my husband were busy
taking care of my mother in law who was totally bedridden
due to different co-morbidities.
Health Home Care
• We got to know how care providers in families are impacted by this
and need knowledge about special age-friendly technicality to care for
dependent elderly at home.
• As I had learned about elderly care in Australia, I started to think of
ways and ideas to provide proper care and services to old aged people.
• In my view, all elderly people are gods who need respect, love, and
affection.
• My main aim at that time was to serve the old age community.
• I received good support from my friends and family to precede the
steps catching my view for old people and old age home. In the
beginning, everybody showed the presence of social stigma in this
subject..

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Old Age

Poor adjustment to lifestyle changes Isolation

Family relationship problems Problems with sexually

Grief Elderly abuse

• In societies with deeply-rooted culture and

Causes of Intergenerational conflict with senior

Factors that influence coping in old age:

Goal of coping strategies:

Factors influencing coping strategies:

Risk factors that may lead to poor coping:

• The Nepalese council of Ministers on 2061 -05-03 BS

• The Labour Act, 1992, fixes minimum wage and

• The Nepal Health Service Act, 1997, outlines various

Medical Treatment of deprived Citizens(Bipanna Nagarik

Social Security Services:

Health insurance policy 2074 (2017):

HHEC delivers necessary care and support through our trained

• We live by the following values:

Quality: We are committed to excellence in the service and care we

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