Yoga Module for Old Age

Purpose of this Module
The MSJE under its jurisdiction has a number of SCHs across the length and breadth of India. It has been a constant endeavor of the Ministry to provide assistance in various ways leading to improvement in the quality of life of the Senior Citizens undergoing rehabilitation. One of the services provided to these individuals is Yoga. It cannot be over-emphasized that the discipline of Yoga being inherently holistic goes a long way in rehabilitation, preservation and promotion of health. Regular practice of Yoga can contribute immensely to the well-being and quality of life of these individuals.
Indian Yoga Association (IYA) is an association of all the important Yoga Institutions in the country. The expertise of Yoga in India is the possession of IYA. With its innumerable Member Institutions spread all over the country, IYA is in an advantageous position to fulfill the need of MSJE in providing Yoga training to the Senior Citizens as mentioned above.
This Module is envisaged to serve as a broad framework or protocol for the Yoga Teachers / Trainers who will impart Yoga training to the participants / inmates of Old Age Homes across the country.
Care and respect towards the elders is an essential cultural trait of ancient Indian culture. One of the ways of taking care of the elders is fulfilled by providing them with the benefits of Yoga practices towards health and happiness.

Yoga, the Great Gift from India

Yoga is an integral part of the rich ancient Indian heritage. The ‘Art and Science’ of Yoga is one of the greatest gifts from India to the world. Yoga traces its origin to the Vedas, the most ancient treasure house of human knowledge. Yoga is as old as humanity! Evidence from ancient civilization extracts show that Yoga existed from the beginning of human civilization. Realizing the importance of Yoga as the best form of practice for holistic health and well-being of humanity, the United Nations General Assembly, on the recommendation of the Hon’ble Prime Minister of India, Shri Narendra Modi, declared 21 June as the International Day of Yoga (IDY). Since 2015, this day is celebrated all over the world with the practice of the Common Yoga Protocol (CYP).

The Discipline of Yoga

Yoga is unique as the best practice to fulfill the twin purposes of human life of experience and emancipation, Samsara and Kaivalya. Accordingly, it addresses the two main segments of the human system, the Material and the Spiritual, i.e., Body and Mind on one side and the Spirit or Consciousness on the other side. It has immense potential as follows:

• As a preventive discipline, it improves immunity and wards off illnesses.
• It preserves and promotes good health.
• As an alternate therapy, it provides relief in illnesses.
• As a healing procedure, it helps in rehabilitation and emotionally empowers an individual to bear the stress and strain of life.
• It increases the life span.
• It enables to control the mind by increasing the power of concentration of the mind.
• It is the best anti-dote to stress and adverse effects of stress.
• On the spiritual front, it transforms consciousness by increasing awareness levels.
• It provides meaning or purpose to human life. 

Yoga is for All

Yoga is for all and everyone irrespective of age, gender, caste, creed, profession, race, religion, region, and nationality. It offers solutions to the problems faced by human beings as such. As an adhyatmic manav samskriti or spiritual human culture it is instrumental in raising the quality of human life and creating better specimen of human beings. To the question “why should one do Yoga?”, the most appropriate answer is, “to become a better human being”. With the popularity of Yoga increasing in geometric progression today, Yoga has the potential of becoming the binding or cohesive force unifying humanity at the universal level for health, harmony and happiness. Modern science has been investigating the efficacy of Yoga from all angles. There are already well-established scientific findings which point towards the positive changes that Yoga brings on the practitioner. Be it to address any type of illness or to improve productivity or to improve the quality of life, Yoga is the Panacea.

Philosophical Root of Yoga

Yoga is one of the six orthodox ancient Indian philosophies (shad aastika darshanas).
The basic text of Yoga darshana or Yoga philosophy is Patanjali’s Yoga Sutras. This sutra work propounds the Aṣṭāñga Yoga or Yoga with eight limbs.

Aṣṭāñga Yoga in Brief

The great sage Patañjali, based on his deep contemplation of the Vedic Wisdom, formulated, and gave to humanity the systematized form of the ‘Eight-limbed Yoga Practice’ known as ‘Aṣṭāñga Yoga’.  It is holistic in that it caters to eight dimensions of human personality, namely, the Social, Personal, Physical, Physiological, Mental, Psychological, Intuitive and Spiritual. Like all other ancient Indian philosophies (except Charvakas), the ultimate purpose of Yoga is to achieve a state of freedom from human sufferings or duhkha. The eight limbs or practices of the Aṣṭāñga Yoga are:

1. Yama (Observances / restraints – Social dimension)
2. Niyama (Observances / restraints – Personal dimension)
3. Āsana (Physical postures)
4. Prāṇāyāma (Breathing practices – Physiological / Mental dimensions)
5. Pratyāhāra (Control of senses by withdrawing them inwards – Mental dimension).

6 to 8. The last three angas viz.  Dhāraṇā (Concentration), Dhyāna (Meditation) and Samādhi (Spiritual Absorption) are together considered as Meditation in Yoga. They cater to the Psychological, Intuitive and Spiritual dimensions of human personality.

Other Traditions of Yoga

In addition to Patanjali’s Ashtanga Yoga, there are several other traditions of Yoga which provide effective practices for mankind. Some of these traditions are as follows: Hatha Yoga, Mantra Yoga, Nada Yoga, Kundalini Yoga, Kriya Yoga, Swara Yoga, Karma Yoga, Bhakti Yoga, Jnana Yoga, etc.
In fact, yogic practices which are popular today viz. shudhi kriyas, asanas, pranayama, bandhas, mudras, etc are sourced in Hatha Yoga. Patanjali’s Yoga Sutras provide principles for the practices of Yoga. Meditation is the highest practice in Yoga.

Old age – Vṛddhāvasthā

“Vṛddhāvasthā is the last part of the lifespan and is inevitably characterized by degenerative changes in the body and mind. Aging refers to a multidimensional process of physical (structural and functional), mental and psychological, and social changes. These changes are always degenerative in nature.
The lifespan of the individual, based upon Ayurveda, can be conveniently classified into three stages: Bālavastha (childhood) may be said to last up to 16years of age; Madhyavastha (young and middle age) lasts from the age of 16 years to 60–70 years; Vṛddhāvasthā or Jīrṇāvastha (old age) refers to the period after 60 or 70 years of age. With enhancing age, the process of change is always one of deterioration and decay. This becomes marked in old age. The nature of disablement happens with the basic dhatus (various anatomical tissues), the indriyas (sensory and motor faculties), the organs (efficiency, potency, strength, etc.), the physiological systems, various mental and cognitive functions (e.g., perception, retention, recollection, imagination, analytic ability, etc.) and awareness levels.

Āśramas or Stations of Life

In ancient India, the average lifespan of an individual was 100 years. This period was classified into 4 stages or ashramas as follows: 1. Brahmacharya ashrama (Student / Bachelorhood extending up to 25 years of age; 2. Gṛhastha ashrama (Householder’s or Married Life – from 25 to 50 years of age; 3. Vānaprastha ashrama (Forest dweller’s life or retired Life – from 50 to 75 years of age; and 4. Sanyāsa ashrama (Renunciate’s Life from 75 to 100 years of age).  There are well laid out detailed guidelines for each of these Āśramas, the following of which will make one lead a healthy, happy, and fruitful life. Old age generally corresponds to the stage of vanaprastha as mentioned above.

With the onset of Old age, one needs to reallocate life priorities and rearrange the lifestyle. Incorporation of appropriate Yoga practices will enrich old age.    

Old age-related health issues

Old age brings with itself a lot of health setback due to aging of the systems. Some of the issues characterizing this setback may be delineated as follows:

Some Common Physical Health Issues

• Digestive System: Indigestion, Constipation, Loss of appetite, Flatulence, etc.
• Excretory System: Urinary Incontinence and infection, Kidney stone, Prostrate issues, etc.
• Cardio-vascular System: Hypertension, Varicose veins, Rupture of blood Vessels, Ischemic Heart Disease, etc.
• Respiratory System: Breathing difficulty, Asthma, Breathlessness, Chronic Cough and Cold, Deteriorating Lung capacity, etc.
• Endocrine System: Obesity, Diabetes, Thyroid Disorders, etc.
• Musculo-skeletal System: Back pain, Spondylitis, Osteoporosis, Stiffness of joints, Arthritis, Inflexibility of muscles, Spasms, Drooping shoulders, etc.
• Nervous System: Insomnia, Anxiety, Depression, Lack of Balance, Forgetfulness, etc.
• Gynaecological System: Menopausal Syndrome, Uterine prolapse, Abnormal uterine bleeding, etc.  
• Skin – Dryness of skin, undue wrinkling of skin, rashes, etc.
• Ophthalmic – Deteriorating vision, senile cataract, glaucoma, etc.
• Dental – gingivitis, pyorrhea, loss of tooth, etc.

Some Common Psychological Issues

• Decline in the mental abilities in old age.
• Steadfastness to bad food habits, behavioral idiosyncrasies, increased neuroticism, etc..
• Unhealthy competition with peer group, obstinacy, etc.
• Excessive & redundant mental activity, indulgence in petty politics, excessive emotional involvement in sectarian activities, purposelessness leading to boredom, etc.
• Cognitive decline and significantly increased risk of depression

The problems stated above are just indicative and neither exhaustive nor uniform among all the cross sections of the old age population. 

Yoga for Old Age

Aṣṭāñga Yoga, the Eight-limbed Path of Yoga, enunciated by Sage Patañjali offers a holistic solution in dealing with human suffering and provides over-riding principles for the practices of Yoga. The eight limbs are:

• Yama (Social observances / restraints)
  • Ahimsa (Non-injury)
  • Satya (Truth)
  • Asteya (Non-stealing)
  • Brahmacarya (Continence)
  • Aparigraha (Non-hoarding)
• Niyama (Personal observances / restraints)
  • Sauca (Cleanliness – Physical & Mental)
  • Saṁtoṣa (Contentment)
  • Tapas (Austerity)
  • Svādhyāya (Study of the Self)
  • Īśvarapraṇidhāna (Surrender to the Īśvara, Supreme Consciousness)
• Āsana (Physical postures)
• Prāṇāyāma (Breathing practices)
• Pratyāhāra (Control of senses by withdrawing them inwards)
• Dhāraṇā (Concentration)
• Dhyāna (Meditation)
• Samādhi (Spiritual Absorption)

Of the eight limbs stated above, Yama and Niyama principles are to be cultivated and followed up throughout life for happy living. Dhāraṇā, Dhyāna and Samādhi, for practice purposes are together taken up as Meditation). Also, Pratyāhāra (withdrawal of senses inwards) is achieved as an outcome of maturity and wisdom on the path of spiritual evolution. Thus, the three important components of the Aṣṭāñga Yoga which are taught and practiced are:

In addition to the above practices, some subtle exercises (sukshma vyayama) and some shuddhi kriyas (purification practices), mudras and mantra chanting as also relaxation practices form essential practices for elder practitioners. 
The above practices can form a progression leading from the body to the mind to the spirit or consciousness. Also, due to limited availability of time spent on the practice of Yoga, the relative time spent between the practices becomes very relevant. As a general rule, in the case of old age home participants, the emphasis in Yoga practices has to increase progressively from the body to the mind to the spirit – from physical practices to breathing practices to meditation..

Rationale of Yoga Practices for Old age Homes

Senior citizens more often lack motivation and interest in initiating and undertaking any strenuous activity on their own due to many reasons. Hence these practices come as a relief to them to bring back their zest and jubilance to life and living and infuse “life to their sunset years of living”.
The aim of using Yoga for Old age should be to slow down the aging process, preserve and improve physical health, attain mental poise and peace, keep body and mind gainfully active, and keep awareness level intact.
The goal of taking Yoga to the residents of “Old age Homes” is also for them to be introduced to and become aware of our age-old traditional practices that were inculcated as part of everyday routine and to promote healthy body, happy and cheerful mind and evolved spirit.
Yoga specifically for Therapy purposes will have to be undertaken on an individual basis and falls outside the scope of this Module. 
What follows is a suggested Module of Yoga for Old age, generally applicable to all the participants.

Some Precautions while Teaching and Practicing

While teaching Yoga for the aged, the following points should be kept in mind:

• The principle of “yatha shakti” i.e. “as per one’s limit / capacity” should be adhered to all the time in every practice. Every participant should be allowed to practice only up to his / her limits. For instance, insistence on achieving the final postures (Āsanas) should be totally avoided. The process of doing the practice is more important than reaching the final point.
• Suitable modifications / variations should be suggested for those who are unable to practice as per prescription.
• Contra-indications of practices should be explained before doing any practice.
• Benefits of the practices should also be listed during rest phases, in between practices.
• It is advisable to use demonstrators to show the practice and the teacher can then simultaneously explain the nuances of the practice.
• As far as possible, practices should be done under the watchful eyes of the teacher, particularly when new practices are introduced.
• Competition should be avoided in any and all practices.
• Instructions should be clear and, in a language, understood by all the participants.
• Ideally, a practice should be first demonstrated and then the participants should be made to do the same.
• Proper protocol should be followed while effecting corrections in the practice of participants.
• Combining breath with postures will help in eliminating the injuries.
• Holding of breath beyond the capacity should be avoided.
• Practices could be done while sitting on a chair wherever applicable.
• Maximum precautions should be taken to ensure that there are no untoward accidents resulting in injuries to the participants.
• Discipline as regards starting and ending time of the Sessions should be strictly adhered to.

Logic behind the Structure of the Module of Practices

The Module of Practices incorporates several practices under various heads like Shuddhi Kriyas, Sushma Vyayama, Asanas, Pranayama, Mudras, Mantra Chanting, Relaxation Practices, Meditation, etc.
The Teacher can choose from these practices (also make necessary modifications) depending upon the needs and capacities of the participants in the group.
Sukshma Vyayama is ideally suited and very effective particularly in the case of these elderly practitioners. It is indented to open out the joints and loosen the muscles thereby bring the beneficial effects in blood circulation, flexibility, etc.
Shudhi Kriyas can immensely benefit by removing the toxics from the body, by stimulating unhindered flow of prana in the body and making the body fit for doing asanas and pranayama.
Āsanas aim at beneficially affecting the structure and functions of the body and thereby restoring health. They can ideally become tools for honing concentration of the mind.
Before teaching pranayama practices, it is essential to ensure that the basic breathing pattern is correct. This is applicable to all the participants. Pranayama practices generally increasing energy and awareness level. With equalized flow of breathing through both nostrils, the mind experiences harmony and is ready to move towards concentration and meditation. These breathing practices can be accompanied by mental chanting of AUM. 
Various Mudras can be incorporated in the sessions exclusively or along with Asanas, Pranayama and Meditation practices.
Meditation practices bring the mind to the state of rest and calmness and are capable to providing the the experience of the blissful no-mind state. 
Yogic Relaxation must be certainly included as part of the protocol for elderly citizens. In fact after every practice compulsory relaxation of a few seconds or minutes should be given to feel fully the effects of the practices. This would ensure mind-body healing, recuperation and regeneration.
The Yoga Teachers will be adequately prepared by means of Workshops for imparting Yoga practices to the participants of Old Age Homes in the most optimum manner. 

Conclusion

The content of this Module, the list of practices incorporated in the Module and guidelines suggested in the Module are meant for providing a framework for imparting the benefit of Yoga practices to the participants / inmates of Old Age Homes. Abiding by the framework, the Yoga Teachers have freedom to choose the particular practices to be taught to the participants, to make relevant and necessary modifications and time allocation inter-alia various practices.

However, the overall aim should be to render health, good cheer and happiness to the participants.

All about the Yoga Module for Old Age