Tag Archives: #connectedness

Ask Yourself 4 Key Questions Everyday: Redesign Your Wellbeing

Sukham Blog – A monthly column focused on South Asian health and wellbeing.

“Goodbye,” said the Fox. “Now here is my little secret. It is very simple. It is only with the heart that one can see clearly. What is essential is invisible to the eye.” … “It is the time you lavished on your rose that makes your rose so important.” … “Men have forgotten this basic truth, but you must not forget it. For what you have tamed, you become responsible forever. You are responsible for your rose.”’

With these simple words, the Fox in Antoine de Saint-Exupéry’s 1941 classic tale The Little Prince reveals that which makes life truly worth living: appreciating people for who they really are, building relationships based on deep and meaningful connections, and understanding the misplaced value most of us give to superficial and material things.  Hearing the Little Prince recount this story, the pilot who has crash-landed his plane in the desert realizes the need to re-evaluate his own life.

Have you crash-landed in your own desert, your plane’s engine broken, and nowhere to go? Are you hoping for your own little prince to share his secret and guide you to a marvelous world?

How would you begin to design, or re-design your life and your well-being?

The application of design thinking – an approach used in product development to incorporate the end user’s needs and perspective – is not new. A good example is found in the book Designing Your Life: How to Build a Well-Lived, Joyful Life by Bill Burnett & Dale Evans, both professors at Stanford. They guide working professionals through this process to build balanced, productive lives while finding joy and satisfaction in work, love, and play.

We are creatures of habit.  We do many of the same things every day, from the moment we wake up until we go to bed at night, because we’ve trained ourselves – with or without intention – to be that way. It stands to reason that if we are to redesign our lives for better well-being, we will have to retrain ourselves to form new habits. Eleni Hope says that it is much easier to create the changes you crave when your habits empower and support your soul, values, and vision.

My friend Chaplain Dr. Bruce Feldstein, a board-certified chaplain, has developed a compelling approach to implement this re-design for well-being in a gradual, transformative process.  He was an emergency medicine physician for 19 years before deciding that his true calling lay elsewhere, and trained to become a chaplain. He now serves as Founder and Director of Jewish Chaplaincy Services serving Stanford Medicine, a program of Jewish Family & Children’s Services, and is an Adjunct Clinical Professor at Stanford University’s School of Medicine. Drawing on the rich perspective he developed from decades of tending to the medical and spiritual needs of people, and additional insights from research and teaching in medicine, he developed what he terms spiritual fitness exercises to help us form these new habits and re-design our own well-being. 

The key, says Chaplain Feldstein, is to “build practices that increase our capacity for meaning, purpose, and connectedness,” three essential determinants of well-being, and then “engage in these practices to fill our living with well-being.”  Building these practices through repetition creates new habits.

Chaplain Feldstein recommends you begin with Four Questions a Day — inspired by the work of Rachel Naomi Remen MD, professor and pioneer of holistic and integrative medicine, and from research on gratitude. At the end of each day, spend 10 minutes of quiet time to contemplate and ask yourself: 

  1. What surprised me today?       
  2. What touched me today?
  3. What inspired me today?
  4. For what am I grateful?

Consider each question separately. Ask yourself the first question, reflect back on your day until you come to the first thing that surprised you, and jot it down. Then ask the second question, look back for the first thing that touched you, and make note of it. Do the same for something that inspired you, and for which you are grateful. Continue this exercise for three weeks and review your answers to see what you can learn about yourself.  This foundational practice of discovery, wisdom, and well-being gradually “teaches us to live with open eyes and an open heart,” says Chaplain Feldstein, “it increases our capacity for well-being as we develop new ways of recognizing that which is positive and meaningful.”

Through this process, you will learn for yourself what the Fox taught the Little Prince!

The next step in this practice is to reflect on each of these questions as you go through your day. Set aside moments during your day to stop, reflect on the questions, and jot down your response. In doing so, identify and notice the particular response – surprise, being touched, inspired, and grateful. As you continue, you will gradually progress to the stage of noticing these reactions while in the experience, and from there to be able to voice an appropriate comment such as “that’s remarkable,” “I’m touched,” “you inspire me,” or “I’m so grateful you did that.”  In this manner, you improve your ability to focus, sense, notice, allow, appreciate, wonder, reflect and find meaning. You interact with authenticity. This is a pathway to “fashion a world that is increasingly filled with well-being,” asserts Chaplain Feldstein. In addition to the Four Questions a Day practice, he recommends three other exercises to explore: Where Are You? Living Your Questions helps you discover the ‘aliveness’ within yourself; Key Relationships helps you stay emotionally buoyant; and Four Things I Want You To Be Sure To Know assists in healing relationships, finding peace, and dealing with the prospect of losing someone.  

Access Chaplain Feldstein’s Spiritual Fitness Exercises© and begin to redesign your own life today!


Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within the South Asian community. Sukham provides curated information and resources on health and well-being, aging, and life’s transitions, including serious illness, palliative and hospice care, death, and bereavement. Contact the author at sukhaminfo@gmail.com

Spiritual Fitness Exercises ©2020 Chaplain Bruce Feldstein MD, BCC.

With sincere thanks to Chaplain Feldstein and the Jewish Family and Children’s Services for this inspiring resource.

The Greying Population of India Hit with COVID-19

While parents left behind in India are terrified of COVID-19, their NRI children are impatient in a distant land to return back to them. We are worried about our loved ones staying far away. Recently, NRIs settled in US, UK, France, dealt with the rapid transmission of COVID-19. The nightmare of a rapid influx of positive COVID-19 cases among potential foreign returnees is petrifying and we must be wary for the most vulnerable populations in India.

In India, the number of working-age populations suffering from COVID-19 is substantial because of its large middle-aged populace, yet the elderly are just as likely of getting the infection, resulting in fatality; this is due to weaker immunity systems, presence of comorbidities, and slower recoveries from diseases.

A handful of research supports that 60+ people with pre-existing comorbidities like chronic lung, liver, kidney diseases, hypertension, cardiovascular illnesses, cerebrovascular diseases, diabetes, and those dependent on immunosuppressive drugs have a higher chance of COVID-19 infection than the rest.

According to the Center for Disease Control and Prevention (CDC), 80% of COVID-19 associated deaths are among more than 65 years’ age group, with increased deaths in elderly males. Thereby, it becomes a challenge to fight the disease for India where the number of the elderly population is close to the combined population of UK and Italy.

The Health Ministry opined in April that “8.61% cases are between 0-20 years, 41.88% cases are between 21 to 40 years, 32.82% cases are between 41 to 60 years and 16.69% cases above 60 years“. Simple statistics from the current population structure can establish the vulnerability of the greying population- about 8% of Indian population above 60 years’ accounts 17 % of COVID 19 patients; while about 62% Indians 20-60 years have approximately 73% COVID-19 cases. Hence, the elderly is at no less risk than the middle-aged to this novel disease.

India has a propounding 140 million (UN projection, 2020) 60+ population. Majority of the districts across India have 7-10% percent elderly. While, many districts of Southern states – Maharashtra, Himachal, Uttarakhand, Punjab – have more than a 10% elderly population (Fig1: a). Based on 2011 Census, our map indicates that many districts of Rajasthan Madhya Pradesh, Chhattisgarh, Orissa, Gujarat, Kerala, Andhra Pradesh, and Telangana have a high proportion of 60+ elderly who are disabled (seeing, hearing, speech, movement, mental retardation, and mental illness; Fig1: b). Districts with a higher proportion of elderly, especially disabled elderly, require special focus and regular monitoring in the framework of tackling pandemic.

Elderly Population in India, 2011.

(a) Proportion of 60+ elderly; (b) Proportion of 60+ elderly disable

 

Impacts on the elderly are layered. World Health Organization (WHO) has identified mental health as an integral part of overall health in correspondence with physiological, behavioral, and psychological wellbeing of older adults. Gerontological studies have established the association of inadequate social wellbeing and poor elderly health.

Proportion of Elderly Living Alone and The Prevalence of Different Diseases Per 1000

State Living Alone Mental Illness Depressive symptoms Hypertension Diabetes Asthma
Assam 386.90 20.80 656.20 252.80 59.00 80.10
Karnataka 343.10 117.40 592.90 237.90 141.60 72.10
Maharashtra 341.50 5.40 557.00 179.00 90.60 110.10
Rajasthan 378.30 6.10 452.00 142.90 42.00 78.60
Uttar Pradesh 316.00 28.20 552.00 133.60 28.80 100.50
West Bengal 350.00 4.10 567.30 245.10 67.30 64.30
India 341.00 26.80 554.30 181.60 65.70 89.80

 

 

  Source: Calculated from WHO-SAGE 2007 Data

The long lockdown in India is vital to avoid burdening the healthcare system and to suppress the chain of transmission of infection. It is mandatory to take “extra care” of the elderly because social distancing may lead to depression, anxiety, and mental illness, especially among the elderly who are living alone and/or are disabled. The vulnerability of the elderly with less social support can escalate in instances of accessing medical support, transportation, banking, food access, etc.

Income, medical security, and social support are major challenges during and beyond the lockdown period. Although, the central government has announced some financial-welfare schemes and guidelines/instructions in the light of the COVID-19 crisis, the helplessness of the aged needs special consideration.

During this tough time, it is necessary for the government, stakeholders, social welfare organizations, and communities to stand in solidarity to provide the essential supplies (groceries, vegetables- fruits and medicines) to the elderly at their doorstep. We need to take precautionary steps to avoid infecting the older adults by sanitizing and frequently cleaning their belongings like, clothes, spectacles, canes, walkers, beds, toilets, chappals, etc. and encouraging them to get engaged in possible physical activities/works within the home.

In order to bolster our elderly loved ones, we need to assist them through social and mental connectivity. The void of connectedness can be minimized through phone, online calls, messages, or encouraging them to interact with friends/neighbors keeping a safe distance.  We all should stay connected with the aged while staying away to keep the world positive.


Subhojit Shaw is a doctoral fellow at the International Institute for Population Sciences in Mumbai, India (IIPS, Mumbai). His academic quest revolves around population aging, child health, and environmental health.

Aparajita Chattopadhyay with her two decades of teaching and research experience, has contributed well in the fields of public health, gender issues, aging, environment-development, and nutrition. She is a faculty of the International Institute for Population Sciences.

All views expressed are personal.