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Walking towards hope

R Sriram Srinivas, who has multiple disabilities—mental retardation and spastic diplegia—takes a breather during his yoga session at home. P Settu, his yoga therapist, who has been teaching Sriram two years now, says that Sriram used to be inattentive and restless, but now follows instructions well and has mellowed down significantly.  

 

 

Images and text by Naveen P M

Walking towards hope (2/9)

M Vanitha, Sriram's teacher, helps Sriram wear his dance apparel before the start of the 'World Differently Abled Day Cultural Programme' at Don Guanella Special School in Chennai. Due to Sriram's condition, simple tasks such as putting on clothes can become a chore and he often ends up needing some assistance. 

 

Walking towards hope (3/9)

Sriram rides his bicycle—fitted with a custom-made backrest—flanked by special education teacher, G V Arumugam. Arumugam has known Sriram for 15 years and was initially hired to teach him basic reading and writing skills. On Sriram's parents' request, he started to assist Sriram in walking and then taught him how to ride a bicycle so he could improve his muscle tone. 

Read Sriram's story here

 

Walking towards hope (4/9)

R Devi helps Sriram read a clock at Sai Sri Ram Training Centre. Sriram has difficulty reading and writing even basic words, and has a hard time grasping universal concepts such as time, date, and money. Devi is Sriram's favorite teacher. Sai Sri Ram Training Centre has eight students with special needs, two teachers, and a domestic help. The school functions from 10 am to 3 pm and keeps the students busy with a plethora of activities such as coloring, computer games, and yoga.

 

Walking towards hope (5/9)

M R Karthik, physical trainer, subjects Sriram to one of the many "balancing exercises" to improve his balance and correct his "scissor gait". Karthik has been training Sriram for the last two years. "In the beginning, Sriram could hardly stand for a minute on his own and displayed a lot of traits commonly seen in persons with Intellectual Disability (ID), such as lack of eye contact, droning, drooling...," says Karthik.

Read Sriram's story here

 

Walking towards hope (6/9)

Sriram and his classmates from Sai Sri Ram Training Centre perform to a medley of Bollywood songs at the 'World Differently Abled Day Cultural Programme' held in Don Guanella Special School, Chennai. P Dharani Kumar, a professional choreographer, composed the dance moves for this performance. He visits the school every weekend to teach dance to these students. "Sriram usually has trouble recollecting and executing my dance moves but he stepped his game up through some spontaneous moves," he said. 

Read Sriram's story here

Walking towards hope (7/9)

Sriram is ecstatic after receiving a silver medal for the Standing Long Jump event. His driver, D Alvin (right), and Sriram's mother, R Vanitha, gather around to congratulate him, at the Special Olympics Sports Meet held on YMCA Grounds, Chennai. Sriram shares a special bond with Alvin and the two can often be seen engaging in healthy banter. 

 

Walking towards hope (8/9)

Sriram does a lap of backstroke at The League Club, Chennai. His parents introduced him to swimming at the age of seven after a doctor suggested hydropathy as treatment. Sriram has been training under U Sathish Kumar, swim coach for children with special needs, for one year now. Sriram won four gold medals in as many events at two swim meets for para-athletes held last year in Tamil Nadu.

 

Walking towards hope (9/9)

Dr J Paul Devasagayam, Area Director, Special Olympics Bharat, Tamil Nadu, reviews Sriram Srinivas's progress with his mother, R Vanitha, during one of their monthly meetings at his 100-square-foot office in Purasawalkam, Chennai.

 

What does elder abuse look like?

A list of signs of what elder abuse is and the mental health impact of it
Aaheli Dasgupta

At the age of 60, Uma lost her husband, her strong pillar of support. She moved in with her adult children, who initially welcomed her warmly. However, things started to take a turn for the worse when Uma found herself staying alone at home. The children expected her to take care of herself despite having a serious medical condition. Her food habits suffered because her children were used to a different kind of a lifestyle. Soon, Uma found herself hesitating to ask for very basic things like being dropped off to the nearest park, lest her children got irritated. They hardly had time to spend with her; she was seldom included in any major family decision. Uma started to feel isolated, lonely and hopeless. She does not know what to do.

This fictional narrative has been constructed to aid the understanding of this issue by placing it in a real life situation.

World Health Organization (WHO) defines elder abuse as "a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person". In a recent survey by HelpAge India, 50% elderly persons reported abuse. However, experts suggest that there may be more instances of unreported abuse because of the stigma attached to abuse and reporting about it. Abuse can be emotional, verbal or sexual, and may escalate to physical violence. Neglect too counts as abuse. This study shows that in most cases, the person who was being abusive was a trusted individual —adult children, or family—they are living with.

What are the signs of abuse and neglect?

  • Physical signs of violence – visible bruises or cuts, fractures and dislocation  

  • Signs of malnutrition - due to food deprivation

  • Addressing the elderly by derogatory terms/phrases 

  • Calling the person "a burden”, “good for nothing” or by other phrases that attack their dignity

  • Restricting them financially and refusing to provide comforts that are a necessity

  • Ignoring their consent or not involving them in major familial decisions  

  • Serving food that may not fit into the elderly’s diet and at unsuitable hours

  • Torn clothes and shabby appearance (a serious lack of grooming) that may lead to skin infections or sores

An aging person may already be dealing with deteriorating physical and cognitive ability. Research has shown that most abuse and neglect occurs because caregivers are unaware that these behaviors are abusive and are unsure about how adquate care can be provided. There is also discourse on how a caregiver facing burnout is more likely to abuse the elderly, since they feel unappreciated and burdened. In such instances, caregivers must immediately seek professional help.  

Abuse may also occur because of economic reasons. Perpetrators of abuse often force, manipulate or trick the elderly to give up on property or sources of income. This leaves the elderly in a vulnerable situation as they end up becoming more dependent on the abuser. In extreme cases, the elderly is left to seek refuge elsewhere as they do not have the means left to support themselves.  

It has also been seen that some caregivers abuse the elderly —often a parent—if they have been abused  during childhood.

Why the elderly don't report abuse

The person experiencing the abuse may be in denial, feel ashamed, helpless, and may even blame themselves. They may find it difficult to articulate their experience, and feel low self-worth and self-confidence. This may further develop into symptoms similar to depression, and in certain cases, anxiety. Another very common effect of abuse is a strong sense of guilt and even death wishes. Any form of  abuse of the elderly has a severe psychological impact on the person. It is crucial that one seeks help from a mental health professional and in extreme cases, social workers working with this cause.

If you suspect that you may be facing abuse or if someone you know is facing abuse you can call the Elders Helpline at 1090 run by the Nightingales Medical Trust.

References 
1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961478/
2.http://www.sciencedirect.com/science/article/pii/S0140673604171444
 
With inputs from Dr Santosh Loganathan, NIMHANS

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