As populations age, geriatric healthcare increases in importance. Elderly people require more attention and resources to manage their deteriorating health. Modern medicine commonly monitors bio-medical indicators and prescribes medicines to control chronic and geriatric abnormalities on a long-term basis. On the other hand, Traditional and Complementary medicines adopt a holistic approach to healthcare and treat geriatric issues from a different perspective.
According to Traditional Chinese Medicine (TCM) principles, the human body consists of complex visceral systems that perform functions to sustain life. These systems require the ongoing use of energy or ‘Qi’ to mobilise the blood, fluid and hormones. Substance or ‘Jing’ on the other hand, carries out the necessary metabolic activities in the body. In TCM jargon, ‘Qi’ is categorised as ‘Yang’ and ‘Jing’ as ‘Yin’. A healthy body requires the maintenance of a balanced state of ‘Yin’ and ‘Yang’ — opposing forces that are “complementary, interconnected and interdependent”1 — via visceral systems performing normal metabolic functions.
In TCM, the human body inherits ‘Qi’ and ‘Jing’ (including genetic elements) from parents in the form of ‘prenatal essence’ at birth. These essences will deplete and gradually be replaced by ‘postnatal essence’ acquired through food, water and nutrients. Both ‘Qi’ and ‘Jing’ are foundational to good health, but they are continuously affected by the ageing process. The manifestation of a declining state of health is evidenced by abnormal bio-medical indicators shown in medical reports and an imbalanced state of ‘Yin’ and ‘Yang’ from the perspective of TCM.
TCM adopts a holistic approach to tackle pathogens for disease prevention and treatment. This requires seniors to pay attention to a variety of factors related to pathogens.
Unlike the synthetic drugs favoured by modern medicine, TCM uses herbal medicine, acupuncture and physical therapies to rectify imbalances. As herbal medicines are nature-based, many of them can also be consumed regularly as food to delay the deterioration of health. This enables physicians to prescribe ‘food therapy’ to treat chronic geriatric issues with lesser side effects. For example, when elderly people suffer from low energy or blood disorders, tonifying items such as Astragalus (Huang Qi) and Angelica (Dang Gui) can be added to herbal soups to replenish energy and blood and to restore the ‘Yin-Yang’ balance.
TCM adopts a holistic approach to tackle pathogens for disease prevention and treatment. This requires seniors to pay attention to a variety of factors related to pathogens, including microorganisms, their physical environment, social connections, and their lifestyles, to maintain good health.
Microorganisms include bacteria, viruses, fungi and parasites.2Besides adopting modern medicine to deal with pathogens, TCM can diagnose and treat diseases by prescribing treatment based on different TCM syndromes. Typically, microorganism infections can cause a variety of symptoms, including fevers, burning sensations and pain. Medicine or foods with cooling properties can be administered to balance the heat to restore the body’s balance.
Yellow Emperor’s wisdom
Written over 2000 years ago, the Yellow Emperor’s Inner Canon: Plain Questions emphasised a balanced diet with grains for nourishment, fruit for assistance, livestock products for benefits, and vegetables for supplementation. Proper proportions of these food groups provide essential energy. Photo: Edwin Tan / iStock
Local circumstances, like weather and humidity, can foster ‘pathogens’ such as wind, cold, heat, humidity, dryness and dampness. When elderly people are exposed to these conditions over time without adequate protective measures, their stress levels can easily go beyond their body’s limits and make them sick. Therefore, seniors should be aware of adverse environmental conditions and adopt measures to help prevent illness. Again, food therapies can be used as an initial remedy to maintain good health such as taking honeysuckle tea for cooling or ginger tea to warm the body to maintain balance in different weather conditions.
There are also social factors, including human relations, that can cause many mental and physical disorders. Such illnesses are addressed in TCM’s classics, a collection of texts developed over the last two millennia. The classics outline seven emotions: anger, sadness, worry, fear, joy, sorrow and surprise. Each of these emotions could trigger disorders in specific organs, and eventually affect internal body systems via their interconnectivity.
Modern studies have found that individuals with good interpersonal relationships are usually happier and healthier. Especially for elderly individuals, troubling emotions can easily be triggered if they are isolated, lonely and depressed. Unlike physical environmental factors which are easily felt, seniors should not overlook the adverse impact that emotional challenges can have on mental health. As a preventive or curative measure, cultivating a joyful social environment with harmonious relationships could help facilitate gracious ageing.
The next mitigating factor for good health is lifestyle management which typically includes work, exercise, sleep and diet. Even when older individuals no longer have to work, they still need to attend to their health. One way to improve such health conditions is to adopt a regular exercise routine to help rejuvenate metabolism. However, it is necessary for seniors to realise their body’s limits and adopt appropriate exercises to minimise injuries. Keeping a good sleep schedule is also important. Seniors who experience sleep disorders may need medical interventions to prevent deteriorating health caused by prolonged insomnia.
Unlike physical environmental factors which are easily felt, seniors should not overlook the adverse impact that emotional challenges can have on mental health.
Incorporating TCM in Healthier SG
The Ministry of Health (MOH), Singapore is exploring how TCM can complement the Government's Healthier SG plan as part of Singapore's preventive care strategy. This initiative aims to address the needs of Singapore's ageing population by shifting the focus of care from hospitals to the community. Photo: Edwin Tan / iStock
Maintaining a balanced diet is another important factor. Modern dieticians recommend a food pyramid consisting of grain, meat, fruit and vegetable in proper proportions. These would provide life-sustaining nutrients such as protein, carbohydrates, fibre, vitamins and fat. However, TCM uses colours and properties as a preliminary guide to food selection. Ideally, a balanced diet should consist of a variety of both. Specifically, red, green, yellow, white and black foods have different properties that benefit the heart, liver, spleen, lungs and kidneys respectively. This practice can help with disease prevention, as well as the treatment of internal disorders. For example, seniors who suffer from a kidney deficiency condition due to depleting essences may choose to consume more black colour food such as black beans or black sesame. Doing so can help address the deficiency and restore good health.
As Singapore is a gourmet paradise with many food outlets conveniently located, many people are adopting the practice of eating out instead
of preparing food in their kitchens. As such, the preference for convenience and good taste often prevails at the expense of healthier diets. Healthy individuals who eat out regularly should be aware of the trade-offs and make a conscious effort to select a balanced diet. For those who require food therapy, it is necessary to consume more home- cooked meals customised to achieve good health.
In summary, the principles of holism, balance and harmonisation are foundations to good health in TCM. When these principles are applied to geriatric healthcare, individuals are empowered with ancient wisdom to complement modern sciences. The combination of contemporary and traditional medicine could create a comprehensive health management system for seniors to lead a happy, healthy and joyful life in their golden years.
DR GOH CHYE TEE
Dr Goh Chye Tee is the former Director of the NTU Chinese Medicine Clinic and Director of Biomedical Sciences/Chinese Medicine at Nanyang Technological University (NTU), Singapore. Amid his career as an accounting professor, he obtained his Singapore TCM Registered Physician qualification and a PhD from Nanjing University of Chinese Medicine in China. Dr Goh served as a member of the Accreditation Committee and an Examiner at the TCM Practitioners Board, and was an International Peer Reviewer in a WHO ‘Standardisation of Traditional Chinese Medicine project. Dr Goh’s clinical practice covers pain management and gastrological ageing disorders. His research interests include depression and TCM philosophy for better health management.
AUGUST 2023 | ISSUE 11
THE ART, SCIENCE AND GOOD NEWS OF AGEING
