A

STUDY
OF
STRESS
AMONG
SENIOR
CITIZENS




TABLE OF CONTENTS

1. Introduction
2. Review of literature
3. Objectives of Study
4. Significance of Study
5. Methodology
6. Data Analysis
7. Result and Discussion
8. Conclusion
9. Limitations of Study
10. Suggestion for further work
11. References
12. Appendix
Questionnaire





TITLE
A STUDY OF STRESS AMONGST SENIOR CITIZENS

Abstract: The purpose of this study is to explore 'Stress' among the aged. Sample
of the study consisted of 50 senior citizens (25 male senior citizens and 25
female senior citizens). Their ages ranged between 50 to 60 years. They belong
to middle and high socio-economic status. Hamilton Anxiety Rating Scale has
been used for the study. Result reveals that a significant difference do exist
regarding stress between male and female senior citizens.




INTRODUCTION

Selye (1974) postulated stress 'as the body's response to different conditions like
fear anger, emotion and other external factors'.

Stress can affect anyone, anytime, anyplace. What's important to know is that
stress can actually be good for you (eustress). It is only when stress reaches
unimaginable levels that it hinders your progress and makes you feel frustrated
and sad (distress). This theory was proposed by Hans Selye, a pioneer in the field
of stress.

When confronted with a stressful situation, the human (due to genetic
programming) retreats to its survival instincts. Our ancestors had much sharper
senses of sight, smell, touch, hearing and taste. This is because they needed
these while hunting for food and to detect the presence of predators. This is
aptly termed 'the fight or flight response'. This response is alive and active even
today. It causes the release of steroids (cortisol) and adrenaline from various
glands in the body. These hormones spur all the systems, like respiratory, cardio-
vascular, abdominal, endocrine and nervous systems, into overdrive.



The result of stress:

Body's reaction: Food is stored as carbohydrate, protein and fat to be used when
the need arises. This causes weight gain.
Brain's reaction: Certain chemicals are released causing fatigue and lethargy.
They retard short-term memory and affect mental processing speed leading to a
decline in mental tasks.

Physiological signs of stress:

Immediate:
1. Cold, clammy, shaky hands
2. Sweating palms and soles
3. Tightening of muscles
Long-term:
1. Immunity weakens
2. Gastro-intestinal problems like constipation, irritable bowel
syndrome
3. Unexplained fatigue
4. Sleeplessness
5. Longer recovery from injury
6. Endocrine system imbalance

Mental signs of stress:
1. Hostility
2. Under/overeating
3. Irritability
4. Listlessness

Stress is you body's response to change. It's a very individual thing. A situation's
that one person finds stressful may not bother someone else. For example
consider this scenario; You are on a roller coaster ride. As the roller coaster
gathers pace, you feel happy and excited. Other people are screaming and
wailing. Some are hysterical with fear. Clearly, the same stimulus can evoke
different reactions in different people. What could be horrifying to someone
could be gratifying to you. As the saying goes, one man's food is another man's
poison. There's no way to say that one thing is bad or stressful because
everyone's different. Not all stress is bad, either. Speaking to a group or
watching a close football game can be stressful. but they can be fun, tfoo. Life
would be dull without some stress. The key is to manage stress properly,
because unhealthy responses to it may lead to health problems in some people.

Stress is a normal part of life. In small quantities, stress is good; it can motivate
you and help you become more productive. However, too much stress. or a
strong response to stress can be harmful. How we perceive a stress provoking
event and how we react to it determines its impact on our health. We may be
motivated and invigorated by the events in our lives, or we may see some as
"stressful" and respond in a manner that may have a negative effect on our
physical, mental and social well-being.

If we always respond in a negative way, our health and happiness may suffer. By
understanding ourselves and our reaction to stress-provoking situation, we can
learn stress more effectively.

To identify the nature of stress widely accepted definition of stress is required,
"Stress is body's reaction to a change that requires a physical, mental, and
emotional adjustment or response".

Stress is of two types:

Eustress (good): can be fun, exciting and energizing, especially in the short
term. We perform better and faster.
Distress (bad): which usually change, break and hurt the person
emotionally, physically. According to ropes (2008) stress is a psychological
response to events that upset our physical safety or emotional equilibrium, the
body defense kicks into high gear in a rapid automatic process known as the
flight response. Wright (1975), suggested signs to include heart pounding in the
chest, tensing of muscles, fast breathing and every sense on red alert.

According to Dozie (2003), the mind and body are in mutual two ways integrated
communication such that any turbulence in one tilts the other. He continued by
saying body malfunction originally triggered by psychological forces or not, can
exert a profound impact on mental behavior. Stress is an occasional attribute of
every person's ecology. It is the pressure, tension or worry resulting from
problems of meeting the challenges in life.

According to Bechr and Newman (1987), stress is a condition of strain on
somebody's emotion, though process and physical condition that threatens the
individual's ability to cope with the environment. Selye (1974) postulated stress
as the body's response to different conditions like fear, anger, emotion and
other external factors.

Auerbach and Grambling (2009) defined stress as an unpleasant state of
emotional and physiological arousal that people experience in situations.

Dictionaries (2009) define stress as strain felt by somebody that could be mental,
emotional, or physical strain caused by anxiety or overwork. It may cause
symptoms as raised blood pressure or depression.

Individuals face difference challenges, hindrances and pressure hard to handle.
When one feels overwhelmed or unsure of how to meet the demands placed on
him, stress is experienced. In small dose, stress can be beneficial for instance
that gives an individual a push needed to remain motivated and a student to
study for an examination instead of going to party or watch television. But stress
becomes a threat to mans physical and emotional wellbeing when life's demand
exceeds mans ability to cope.

Some of the major symptoms of stress are: cognitive and emotional symptoms
(memory problems, poor judgment, seeing only negative, moodiness,
depression, irritability), physical and behavioral symptoms (aches and pains,
diarrhea or constipation, eating more or less, sleeping too much or too little,
nervous habits).

Stress can be caused by mainly reasons like; major life changes, work
relationships, financial problems, being too busy, children and family. All these
are external causes that lead to stress. Not all stress is caused by external
factors, stress can also be generated or internal like: inability to accept
uncertainty, pessimism, negative self-talk, unrealistic expectations,
perfectionism, and lack of assertiveness.

It is important to deal with stress so that person can live his/her with full energy
and confidence. 'Stress Management' and 'Relaxation Techniques' plays a crucial
role to deal with stress.

People experiencing stress are more likely to report hypertension, anxiety or
depression and obesity. Women, in particular, report feeling the effects of
physical stress on their health then men.




TYPES OF STRESSORS


Situation that are considered stress provoking are non as stressors. Stress in no
always a bad thing. Stress is simply the bodys response to change that creates
taxing demands. Many professionals suggest that there is a difference between
what we perceive as positive stress, and distress, which refers to negative stress.

Positive stress has the following characteristics:
Motivates, focuses energy.
Is short-term.
Is perceived as within our coping abilities
Improves performance
Negative stress has the following characteristics:
Causes anxiety or concern.
Can be short or long term.
Is perceived as outside of our coping abilities can lead to mental and
physical problems.




STRESS AMONG SENIOR CITIZENS


Old age is generally the chronological age, a universal phenomenon and a
challenge to everyone who reaches it irrespective of occupation skill or learning
(Tungdim et al. 2002). In most gerontological studies, persons above sixty year of
age are coined as old and comprise the elderly sector in India. The population
projection made by the UNESCO indicated that the proportion of the age above
sixty is likely to go 12.3 percent in 2025 in India. We therefore, need to pay
proper attention to the quality of life of the older persons in almost all the
countries elderly women outnumber the elderly man. Rapid aging trends present
new challenges to government, families and the elderly themselves
(Ramachandran and Radhika(2002)).

The problem of senior citizens has become a social problem in Indian society.
The changes in the demographic structure during the last few decades in
developing countries of the world has made the aged a socially more noticeable
section (Bhatia 1983). Moreover, modern society has undergone a waste
transformation due to breaking up of joint family system, technological
revolutions and attitude of younger generations towards old age. All these have
accelerated the problems of elderly particularly women. The economic
inadequacy of the nuclear family is resulting in the neglect of its members. The
traditional roles are slowly being replaced with insignificant roles after
retirement. The problems experienced are more acute who are economically
dependent solely on the families. In the advancing age, when the aged loose
friends, job status, power influence, income, health, etc. bring host of problems
related to physical, economic, social and psychological aspects.

Old age presents its special and unique problems but these have been aggravate
due to the unprecedented speed of the socioeconomic transformation leading to
a number of changes in different aspects of living conditions. The needs and
problems of the elderly vary significantly according to their age socioeconomic
status, health, living status and other such background characteristics (Siva Raju
(2002)) for elders living with their families - still the dominant living arrangement
- their economic security and well-being largely depends upon the economic
capacity of the family unit (Alam, 2006). In traditional Indian society, the
informal support systems of family, kinship and community are considered
strong enough to provide social securities to its members, including older
people. Urbanization, industrialization and the ongoing phenomenon of
globalization have cast their shadow on traditional values and norms within
society. Gradual nucleation of the joint family, erosion of morality in economy,
changes in the value system, migration of youth to urban areas for jobs or work
and increasing participation of women are important factors responsible for the
marginalization of older people in rural India. As a result the elderly depend on,
'money-order economic' and their intimacy with their children is only from a
distance (Vijay Kumar, 1999). The many psychological, economic, emotional and
interpersonal facts of aging influence the social functioning and wellbeing of
individuals in different ways. Changing traditional values, mobility of the younger
generation, changes in family structure and role of women have contributed to a
'crisis in caring' for the elderly (Prakash, 2004). Many facts of the generation gap
contribute to marginalization of older persons and their wisdom by the younger
generations, leading to conflicts, lack of respect and decline authority, neglect
and sometimes even exploitation or abuse. Given the rate of population aging
the developing countries like India are experiencing, there is a need to focus on
aging issues and to take effective measures for improvement in the quality of
life of elderly in general and elderly women in particular. A country as large and
as complex as India needs to work out an extensive plan for the care and
wellbeing of the elderly as necessary according to differences in levels of
urbanization as well as in cultural and familial systems. The rural poor, who
mostly work in the informal or unorganized sector insecure employment,
insufficient income and lack of access to any form of social security and good
quality and affordable health care. Generally they have to pay a large percentage
of their income for basic care services. As the interrelation of health and
economic status continues throughout ones life, it is of special importance
among the elderly whose livelihood depend on their physical abilities and do not
have any provision for economic security. Social security, pensions, though
meager in amount, create a sense of financial security for the elderly who
benefit through schemes such as old pensions, widow pensions, agricultural
pensions and pension for informal sector workers. However the corporation of
elderly who benefit from these schemes has to be improved significantly.

Growing old in a society that has been obsessed with youth may have a critical
impact on the mental health of many people. This situation has serious
implications for psychiatric nursing.

Mary C. Townsend (2006)

Aging population can be seen as a success story for public health policies and for
socioeconomic development, but it also challenges society to adapt, in order or
maximize the health and functional capacity of older people as well as their
social participation and security.

WHO (2007)

In India life expectancy at birth has increased by 20 years to the past five
decades the average life span today is 66 years. Today there are about 77 million
people aged above sixty years of age in India.
Leaders of Social institutes have largely ignored the massive life changes seniors
face.

Sathya Venkatesh (2010)

Problems of the elderly include physical changes, psychological changes,
personality changes and psychosocial changes among elderly individuals usually
face a high risk developing mental problems. Psychological changes like
agitation, crime spells, irritability and stress.

Sreevani R. (2007)

Stress may be defined as a real interpreted threat to the psychological or
physiological and/or behavior response. It is bodily or mental tension resulting
from factors that end to alter an existing equilibrium.

Lalitha K. (2007)




REVIEW OF LITERATURE

Five recent researches including a recommendation that preparation for aging
and appropriate intervention in could result in successful aging (Bode et al. 2007;
Coutu, 2002). Conceptualizing and documenting successful aging, but few
studies have included seniors as "essential sources of knowledge" (Holstein &
Minkler, 2003, para 8). The specific problem is the lived experiences and
perceptions of women of the traditionalist generation (born between 1990 and
1945) remain undocumented. If the voices of the women are lost with their
passing these resources for overcoming barriers to successful aging and
improving coping skills will also be lost for future generations. The current
qualitative study with a phenomenological design was based on the life
experiences of 25 Midwestern women of the tradionalist generation, who were
regular attendees and two rural senior centers. The director of each center also
provided data on the perception of these as successful agers. Purpose of the
study was to develop a profound understanding of the lived experiences of the
senior citizens in the mid-west and their coping skills relating to the aging
process. Personal, one-on-one narrative interview resulted into insights into
characteristics of senior who have defined themselves as successfully coping
with effects of aging, those who have practical experience in coping with aging .
The survey instruments included the interviewer and questionnaire which served
to guide the interviews (see the appendix) among the responses, patterns were
discerned to explicate the phenomenon and to assist leaders in the fields of
geriatrics and policy makers in making informed decisions about this population.


Zweig (2005) posited, Suicide among older adults represents one of the most
salient and intractable problems in geriatric mental health".

According to Sandilands and Bateman (2007), suicide is a "major health issue
worldwide", with the greatest number of suicides occurring among the elderly.
They cited "co-morbidity and social isolation as well as greater physical
vulnerability to drugs, as the underlying causes of the higher suicides for the
individuals aged sixty years and older.

According to the authors of the Report Elderly in U.S. (2007), older adults are
less likely to seek help and are more lethal in their suicide attempts. The article
indicates few suicides prevention programs targeting the elderly exit because of
a lack of funding for the program and the apparent lack of concern for the
elderly suicides. The senior citizen population is growing exponentially from
1994 to 2004,"the number of Americans aged 45-64 who will reach 65 over the
next two decades increased be 29%" (Administration of Aging, 2005). Because of
this population leaders at institutions such as senior citizens center face
mounting concerns regarding the socialization and educational needs of seniors.
gerontology scholars and educational researches agree that a general problem
exists because leaders and policy makers have not addressed the problem of
preparing senior citizens foe successful aging (Kahn 2002, McGuire 2003,
Noddings 1965, Rowe Kahn 1999).

Louise H. Philip et. al . (2002) conducted a study in age and the understanding of
emotions. Mayor and colleagues have developed a battery of emotional
intelligence tasks (the Multidimensional Emotional Intelligence Scales ( MEIS)
that predict key criteria such as life satisfaction and empathy for others and
along with their ability to regulate their mood. In the study 30 young (aged 20-40
years, M_29.9, SD_7.1), and thirty old (aged 60-80 years, M_69.2 years, SD_6.1).
The younger group comprised 11 men and 19 women, the older group 15 men
and 15 women. The age groups differed in terms of years of education,
t(58)_2.98, p_.01(youngM_14.45 years, SD_2.79, old M_12.20 years, SD_3.11).
Performance of the young and old age groups on the tasks are reported: There
was no effect of age group on the two emotionally. There was no significant age
effect on identifying motions in the faces, the older group performed
significantly worse than the young group. There were no age effects on surprise,
disgust or fear. However, elder people were significantly more likely to make
error on anger and sadness.

There appears to be a significant difference in the health situation of the elderly
living in rural areas in composition to those living in urban areas. The elderly
living in rural areas appear to be much healthier as compared to those residing in
urban areas. Interestingly, the prevalence of chronic disease among females is
higher than that among males in the case of urban areas while reverse is the
case in rural areas (CSO, 2002). The prevalence of various types of physical
disabilities was found to be more prevalent in rural areas as compared to urban
areas.

A study by Moneer Alam (2006), indicates that a very large majority of the
elderly suffer from curtailed functional abilities in physical ( eating, bathing,
dressing, walking, climbing stairs, getting-up from a sitting position, etc.) as well
as in sensory (hearing and vision) health domains. This forces them to rely on
formal or informal help in their day-to-day activities. These problems of
incapacitation are found to be particularly acute among the lower income
groups. Women are the worst sufferers, with less of filial support.




OBJECTIVE OF THE STUDY




To study the stress level among senior citizens (male and female) living with
and without family comparatively.

To develop a comparative understanding of the phenomenon of stress among
senior citizens.

To identify techniques or strategies or interventions to effectively cure and
control of the problem of stress among senior citizens.





SIGNIFICANCE OF THE STUDY



RATIONALE:


Much research has been done about the possible consequences of stress among
senior citizens. Understanding of reason behind the problem is important so that
if we will change the external as well as internal environment, we will be able to
save senior citizens from stress.

Consequences may be mild or severe which may even disappear after a short
period or last for longtime; and effect the old age people physically,
psychologically, and behaviorally. The researcher is interested to do a
comparative study of stress among senior citizens. Therefore, it is very pertinent
to identify stress related factors causing stress among senior citizens. Thus, in
the present research work a study was planned to find and analyze stress factor
among the male senior citizens and female senior citizens. Thus, in the present
research work a study was planned to find and analyze stress factor among the
male senior citizens and female senior citizens. So HAM-A was conducted of the
sample to analyze the stress level among male and female senior citizens.



MEASURES:


The HAM-A is one of the first rating scales developed to measures the severity of
anxiety symptoms, and is still widely used today in both clinical and research
settings. The scale consists of 14 items namely:

Anxious mood
Tension
Fears
Insomnia
Intellectual
Depressed mood
Somatic (muscular)
Somatic (sensory)
Cardiovascular symptoms
Respiratory symptoms
Gastrointestinal symptoms
Genitourinary symptoms
Autonomic symptoms
Behavior at interview

Each item is defined be a serious of symptoms, and measures both psychic
anxiety (mental agitation and psychological distress) and somatic anxiety
(physical complaints to anxiety). Responses were taken by the subjects on a 5
point likert-rating, 25 male and 25 female senior citizens were studied at their
homes respectively.


The major aim and objective of this study was:

TO find out stress among senior citizens.

Hypothesis:

There may be a gender differences between male senior citizens and female
senior citizens regarding stress.

Women will show more stress level in comparison of men.






METHODOLOGY


SAMPLE

Sample of the study consisted of 50 senior citizens (males = 25, females = 25).
Their age ranged between 50 to 70 years. The mean age being about 60 years .
They belong to middle and high socio-economic status living in urban area
namely South-West Delhi.

TOOL USED

The HAM-A is one of the first rating scales developed to measures the severity of
anxiety symptoms, and is still widely used today in both clinical and research
settings. The scale consists of 14 items namely:

Anxious mood
Tension
Fears
Insomnia
Intellectual
Depressed mood
Somatic (muscular)
Somatic (sensory)
Cardiovascular symptoms
Respiratory symptoms
Gastrointestinal symptoms
Genitourinary symptoms
Autonomic symptoms
Behavior at interview

Each item is defined be a serious of symptoms, and measures both psychic
anxiety (mental agitation and psychological distress) and somatic anxiety
(physical complaints to anxiety). Responses were taken by the subjects on a 5
point likert-rating, 25 male and 25 female senior citizens were studied at their
homes respectively.

The scale was conducted at the time and place convenient for the subject
especially at their home and workplace. Subjects were told about the purpose of
the research study, and were requested to co-operate, they were convinced that
their identity and responses would be kept confidential. Only those who were
willing to respond were taken for research.

It was ensured that the subjects understood the items. Subjects were not feeling
comfortable to answer on the scale and then subjects answered on it. The
administration took about 10 to 15 minutes per subjects were thanked for their
co-operation.


ETHICAL CONSIDERATION

Permission was taken from family members.
Permission was taken from the subjects.


DATA ANALYSIS

TABLE NO. 1
Comparison of scores of women belonging to working and non-working group

Gender N Mean SD t-value Level of
Significance
Male 25 13.64 8.76 3.48

Significant
(.01, .05)
Female 25 23.56 11.35

Table no. 1 displays analyzed data regarding comparison of stress level among
male senior citizens and female senior citizens in terms of critical value. It is
obvious from the table that obtained t value 3.48 is more than minimum
significant value 2.70 at 0.01 and 2.02 at 0.05 at level of significance. It means
that male and female senior citizens do differ significantly in terms of their
stress.There exists difference in mean scores of the male and female.


RESULT AND DISCUSSION


To identify the nature of stress widely accepted definition of stress is required
"Stress is the body's reaction to a change that requires a physical, mental and
emotional adjustment or response".

We generally use the word stress when we feel that everything seems to have
become too much, we are overloaded and wonder whether we really can cope
with the pressures placed upon us. Anything that poses a challenge or a threat
to our well-being is a stress. Some stresses get you going and they are good for
you, without any stress at all many say our lives would probably feel pointless.
However, when the stresses undermine both our mental and physical health
they are bad.

Being a comparative study, stressful events were identified and compared both
in male and female senior citizens.

Stress was measured on the male and female senior citizens and after analyzing
the data through t-test it was found that obtained t-value 3.48 is more than
minimum significant value 2.70 at 0.01 and 2.02 at 0.05 level of significance.
Thus, results indicate that significant difference exists in male and female senior
citizens regarding their stress level.

In the literature review, study like:

53 percent among elderly males are literate; the figure drops to only 20 percent
among elderly females. Elderly males are more economically active as compared
to elderly females. The data on old age dependency ratio (NSSO, 2004).

The loss of the decision-making power is experienced more by those who have
surrendered their property in the favour of younger members and thus have no
control over the sources of income. The loss of status and decision-making
power is felt more by ageing women than men (Nandel et. al. 1987, Siva Raju,
2004). Khan and RAjkwar(2010), in an empirical study of 320 people over 60
years of age in Delhi.

Based on a study of hospital data, Pathak (1982) has found that 62.6 percent of
the elderly patients had cardiovascular ailments, 42.4 percent had
gastrointestinal problems, 32.5 percent had urological problems, 19.8 percent
had nervous breakdowns, 19.2 percent had respiratory problems, 11.6 percent
had lymphatic problems, 7 percent had high or low blood pressure, 11.2 percent
had ear and eye problems, 4.8 percent had orthopedic problems, 5.7 percent
had surgical problems while 37.3 percent of the elderly had problems with all
their systems.

Above studies and present study supports that significant difference exists in
male and female senior citizens.


TECHNIQUES AND INTERVENTION TO CURE STRESS

1.Meditate

If you're thinking meditation means twisting your body into an uncomfortable
position and uttering "oohs" and "mms" for an hour, guess again. Any repetitive
action can be a source of meditation, says Herbert Benson, MD, author of The
Relaxation Response and director emeritus of Benson-Henry Institute for Mind
Body Medicine in Chestnut Hill, Mass. This includes walking, swimming, painting,
knitting -- any activity that helps keep your attention calmly in the present
moment.
When you catch yourself thinking about your job, your relationship or your
lifelong to-do list, experts say to simply let the thought escape, and bring your
mind back the repetition of the activity. Try it for just 5 to 10 minutes a day and
watch stress levels drop.

2. Picture Yourself Relaxed

Is your mind too talkative to meditate? Try creating a peaceful visualization, or
"dreamscape". To start, simply visualize anything that keeps your thoughts away
from current tensions. It could be a favorite vacation spot, a fantasy island, that
penthouse in New York City -- or something "touchable," like the feel of your
favorite silk robe or cozy sweater.

The idea is to take your mind off your stress, and replace it with an image that
evokes a sense of calm. The more realistic your daydream -- in terms of colors,
sights, sounds, even touch and feel -- the more relaxation you'll experience.

3. Breathe Deeply


Feeling stressed evokes tense, shallow breathing , while calm is associated with
relaxed breathing, says Michael Lee, author of Turn Stress into Bliss and founder
of Phoenix Rising Yoga Therapy in Bristol, Vermont. So to turn tension into
relaxation, he says, change the way you breathe.

Try this:

Let out a big sigh, dropping your chest, and exhaling through gently pursed lips,
says Joan Borysenko, PhD, director of Harvards Mind-Body Clinical Programs.
Now imagine your low belly, or center , as a deep, powerful place. Feel your
breath coming and going as your mind stays focused there. Inhale, feeling your
entire belly, sides and lower back expand. Exhale, sighing again as you drop your
chest, and feeling your feeling your belly, back and sides contract. Repeat 10
times, relaxing more fully each time.


INTERVENTIONS


Progressive Muscle Relaxation (PMR)

Origins:
Progressive muscle relaxation (PMR) is a technique for reducing stress and
anxiety by alternately tensing and relaxing the muscles. It was developed by
American physician Edmund Jacobson in the early 1920s Jacobson argued that
since muscle tension accompanies anxiety, one can reduce anxiety by learning
how to relax the muscular tension. PMR entails a physical and mental
component.

Method/Pathophysiology:
The physical component involves the tensing and relaxing of muscle groups over
the legs, abdomen, chest, arms and face. In a sequential pattern, with eyes
closed, the individual places a tension in a given muscle group purposefully for
approximately 10 seconds and then release it for 20 seconds before continuing
with the next muscle group. The mental component requires that the individual
focuses on the distinction between the feelings of the tension and relaxation.
With practice, the patient learns how to effectively relax in a short period of
time.
Relaxation must be attempted in order to reduce pain or pain perception and
tension, create a pleasant mental state, reduce anticipatory anxiety, reduce
anxiety as a response to stress, increase parasympathetic activities, increase
knowledge concerning muscle tension and autonomous stimuli, improve
concentration, increase the feeling of control, improve the ability to block inner
talk, energize and improve sleep, decrease the cardiac index, lower blood
pressure, warm or cool body parts, enhance performance of physical activities
and help in the relationship with others. Therefore, the individual is taught by a
trained professional.

Sample of this Autogenic Training (AT)

Origins: Autogenic training (AT) is a self-relaxation procedure by which a psycho
physiological determined relaxation response is elicited. This relaxation
technique was developed by Johannes Heinrich Schultz. AT aims to achieve deep
relaxation and reduce stress.

Method/Path physiology: In AT the individual learns a set of directions/exercises
that command the body to relax and control breathing, blood pressure,
heartbeat and body temperature. AT consists of six standard exercises that with
the use visual imagination and verbal clues- make the body feel warm, heavy,
and relaxed. The person learns each exercise by reading about it or watching a
teacher, then practicing it for a few minutes several times a day. Mastering the
exercises, either from an instructor or on one's own, usually requires 4 to 6
months.

Results/Benefits: A meta-analysis of clinical outcome studies in AT fount that it is
useful in a range of diverse disorders including tension headache/migraine, mild-
to-moderate essential hypertension, coronary heart disease, asthma bronchial,
somatoform pain disorder (unspecified type), Reynaud's disease, anxiety
disorders, mild-to-moderate depression/dysthymia, and functional sleep
disorders.


CONCLUSION

Thus the findings of the study, describes that significant difference do exists
regarding stress among male and female senior citizens. HAM-A scale was used
for the research. Total 50 samples were used (25 male and 25 females).

Many studies have found that there is more effect of stress on females as
compare to males. According to studies female senior citizens experience more
stress because the loss of status and decision-making power is felt more by
ageing women than men. The main reasons for above health problems may be
due to lack of proper food, stress or lack of proper treatment provided by their
family members. The present findings are in line with those of Mahajan (2006)
who also reported that elderly people generally suffer from general weakness,
sleeplessness and poor eye sight.

Elderly females faced numerous socio-psychological problems like stress,
declining authority, lack of respect in the family, loneliness, difference of opinion
with family members etc. than elder males.

Therefore, it can be said that female senior citizens faces more stress than male
senior citizens.



LIMITATIONS OF THE STUDY


Study is very small (50 N) due to time constrain.
Only subjects of South West Delhi region were considered in the study.
To measure stress, both qualitative and quantitative measure could have been
adopted to gain more insight regarding stress among the male and female but,
due to time constrain, researcher was not able to include such methods in her
study.
This study has been confined only to urban area.
Sample was drawn from only middle and high socio-economic status.





SUGGESTION OF RESEARCH TOPIC FOR FURTHER STUDIES



This study has thrown new light on the stress factor in lives of senior citizens
living in urban areas. This study has been confined only to urban area and
particularly South West Delhi only. Investigation like the present study one may
also be undertaken in other parts of the state or country and even research can
also be conducted on the following topics:

To study stress among divorced and widow senior citizens.
To study stress among rural and urban senior citizens.
To study stress among early and late married senior citizens.
To study stress among literate and illiterate senior citizens.
To study stress among senior citizens from low, middle and high socio-
economic status.



REFERENCES


Ramachandran R, Radhika R 2006. Problems of elderly women in India and
Japan. Indian Gerontology.


Bakshi R, Rajneesh, Sandhu P, Harpainder 2007. Problems of the ages living
with families and in senior citizen homes.

Mahajan S 2006. Problems of senior citizens in India.

Bhatia HS 1983. Ageing and Society - A sociological study of the retired public
servants.

Demographics of Population ageing in India Lekha Subaiya and Dhannajay W
Bans.

"Ageing exploding the myth" 2005. form WHO booklet "Ageing the health
program".

Acharya Anoop, 2005 "the aging Individual".

Anbu. S, et.al. 2008 "Geriatric nursing"

August K.J. et. al. (2007) " The joint effects of life stress and negative social
exchanges on emotional distress", Journal of Gerontology.

www.stress.org

wikipedia.org

Lazarous R. S. Delings A, Psychological stress and coping in ageing.

S. E. Jackson and R. S. Schuler (1985) a meta-analysis on stress.





APPENDIX

QUESTIONNAIRE

Below is a list of phrases that describe certain feeling that people have. Rate the
patients by finding the answer which best describes the extent to which he/she
has these conditions. Select one of the five responses for each of the fourteen
questions.

0 = Not Present
1 = Mild
2 = Moderate
3 = Severe
4 = Very Severe

1. Anxious Mood: worries, anticipation of the worst, fearful anticipation,
irritability.


0 None

1 Mild

2 Moderate

3 Severe

4 Severe, grossly disabling


2. Tension: feeing of tension, fatigability, startle response, moved to tears easily,
trembling, feelings of restlessness, inability to relax.



0 None

1 Mild

2 Moderate

3 Severe

4 Severe, grossly disabling
?
?
?
?
?
?
?

5.Intellectual (Cognitive): difficulty in concentration, poor memory.



0 None

1 Mild

2 Moderate

3 Severe

4 Severe, grossly disabling


6. Depressed Mood: loss of interest, lack of pleasure in hobbies, depression,
early waking, diurnal swing.


0 None

1 Mild

2 Moderate

3 Severe

4 Severe, grossly disabling


7. Somatic (Muscular): pains and aches, twitchings, stiffness, myoclonic jerks,
grinding of teeth, unsteady voice, increased muscular tone.


0 None

1 Mild

2 Moderate

3 Severe

4 Severe, grossly disabling

?
?
?
>
>?


10. Respiratory Symptoms: Pressure or constriction in chest, choking feelings,
sighing, dyspnea.


0 None

1 Mild

2 Moderate

3 Severe

4 Severe, grossly disabling

11. Gastrointestinal symptoms: difficulty in swallowing, wind, abdominal pain,
burning sensation, abdominal fullness, nausea, vomiting, stomach
gurgling/grumbling, looseness of bowels, loss of weight, constipation.


0 None

1 Mild

2 Moderate

3 Severe

4 Severe, grossly disabling