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Diabetes and dementia are two prevalent health conditions that have been the focus of extensive research in recent years. While each condition has its own distinct characteristics, emerging evidence suggests a strong correlation between diabetes and an increased risk of developing dementia.  As Head of Learning at Epoch Elder Care, **[an assisted senior living facility](https://www.epocheldercare.com/assisted-living)**, I am deeply committed to promoting preventive health measures. Through this blog, I will delve into the correlation between diabetes and dementia, exploring the shared risk factors and the vital role of lifestyle choices in preventing these conditions. Join me on this journey to uncover the best strategies for optimal brain health and well-being, especially for elders. 

#### **Understanding the Correlation:**

-  **Impact of High Blood Sugar Levels on Brain Health**

Chronic hyperglycemia promotes cognitive decline through glycation, where excessive sugar molecules react with brain proteins, forming harmful compounds that negatively affect brain tissue and cognitive function. Maintaining stable blood sugar levels is vital to safeguard cognitive abilities and reduce the risk of neurodegenerative conditions. 

-  **Insulin Resistance and Cognitive Decline**

Insulin resistance and impaired signaling are linked to dementia and cognitive decline, affecting brain cells and increasing vulnerability to neurodegenerative processes. Insulin plays a crucial role in brain health and neuroprotection, emphasizing the importance of maintaining proper sensitivity to support cognitive function and reduce the risk of cognitive disorders.

#### **Shared Risk Factors:**

**Age as a Common Risk Factor**

Advancing age is a shared risk factor for diabetes and dementia, leading to higher prevalence in older adults. Age-related changes in insulin sensitivity and brain function are crucial in this relationship, and the cumulative effects of long-term diabetes can significantly impact cognitive health in the elderly, potentially contributing to cognitive decline and neurodegenerative diseases


**Genetic Predisposition**

Genetic predisposition significantly influences the development of diabetes and dementia, with strong familial links and shared genetic factors involved in these conditions. Specific gene variants associated with both diseases highlight the impact of shared genetic pathways on metabolic regulation and brain function.

**Vascular Health and the Diabetes-Dementia Connection**

Diabetes profoundly affects blood vessels and the brain's vascular system, leading to microvascular complications that contribute to cognitive impairment. The interplay between diabetes, hypertension, and cerebrovascular disease increases the risk of dementia, as these conditions collectively harm the brain's blood supply and overall vascular health.

**Alzheimer's Disease and Diabetes: A Key Link**

_(Alzheimer's disease is a specific type of dementia, characterized by progressive memory loss and cognitive decline.)_

Diabetes (specially Type 2) and Alzheimer's disease have a bi-directional relationship, with insulin resistance promoting amyloid beta and tau pathology in the brain. Common pathophysiological mechanisms suggest that addressing one condition may impact the management or prevention of another. Diabetes is also associated with structural and functional brain changes, leading to cognitive decline. It affects hippocampal integrity, memory function, and executive abilities, primarily due to disruptions in glucose metabolism and cerebral energy utilization.

**What non-pharmacological measures can be employed to manage and mitigate the risk of developing diabetes and dementia?**

According to various researches, dietary and lifestyle changes can help to avoid neurodegeneration and promote brain health. Enhancing blood glucose levels may aid in both the prevention and **[treatment of dementia](https://www.epocheldercare.com/epoch-dementia-care-program)**. 

-  **Nutrition**

We should aim to adopt a dietary approach that promotes stable blood sugar and insulin levels (low glycemic), while also minimizing inflammation and providing essential nutrients for optimal brain health.

The following are tips for proper nutrition that should be considered in elder care: 

- Small amounts of nutrient-rich carbohydrates like sweet potatoes, steel-cut oats, buckwheat, etc.
- Whole, unprocessed foods like vegetables, legumes, nuts, etc.
- Whole fruits per day for at least two days in a day
- Use of high-quality oils such as cold-pressed olive oil and oils of nuts and seeds
- Omega-rich foods twice a week
- High-protein foods that can be animal- or plant-sourced
- 8–10 servings of non-starchy vegetables in a day

Apart from that, there are many nutrients that are essential for the brain and its cognitive function. They are as follows:

1. Vitamin A (Essential for neurogenesis and resiliency of the brain)
2. Vitamin C (essential for the growth of neurons, the formation of the myelin sheath, and neurotransmitter synthesis)
3. Vitamin D (essential for cognitive function)
4. Vitamin E (which protects cells from oxidative stress and may help prevent or delay cognitive loss)

At our **[Epoch Elder Care Facilities](https://www.epocheldercare.com/)**, we offer a comprehensive cyclic menu tailored for the elderly, with both vegetarian and non-vegetarian options. Our small, intermittent meal approach fosters better digestion and nutrient absorption. For residents with diabetes, we provide a specialized diabetic diet with low glycemic foods and careful sugar monitoring. We are dedicated to promoting the health and well-being of our elderly residents through nutritious and delicious meals tailored to their needs and preferences.

-  **Monitoring of Blood Glucose Levels**

Blood glucose monitoring is essential in managing diabetes, enabling regular tracking of blood sugar levels. Using a glucose meter, a small blood sample is analyzed, helping individuals understand their body's response to food, activity, and medications for informed decisions. Regular monitoring empowers diabetes management, leading to personalized treatment plans for better health outcomes.

Regular blood glucose monitoring is crucial for elderly individuals with diabetes. To minimize discomfort, we rotate testing sites and follow the doctor's advice on frequency. Periodic HbA1c testing enhances accuracy, ensuring effective diabetes management for our elderly residents' health and well-being.

-  **Stress**

When a body is under chronic stress, it releases hormones that can increase blood glucose level. Apart from the fact that stress causes inflammation of the brain cells, According to a study published in the Alzheimer's & Dementia Journal, brain inflammation is a significant neuropathological route that is relevant to the cognitive decline brought on by Alzheimer's disease.

At **[Epoch](https://www.epocheldercare.com/)**, we firmly believe in the power of engaging activities to prevent stress and promote well-being in individuals with diabetes and dementia. As one of our activities, we thoughtfully plan "Movie Time" on Sundays, featuring movies from their era, which serves as an effective stress-relieving activity. By immersing our elderly residents in the nostalgia of familiar films, we create an emotionally comforting environment, which can reduce anxiety and tension.

-  **Exercises**

A study of the literature turned up 27 studies looking at how exercise affects cognitive performance in adults above 60 years. A strong correlation between physical activity levels and cognitive function was found in 26 of the investigations, indicating that exercise may be a useful strategy to slow down cognitive aging.

At our **[Epoch homes](https://www.epocheldercare.com/our-homes)**, we prioritize the well-being and physical health of our residents at all levels. In our setting, our dedicated caregivers provide  support by assisting residents in both active and passive exercises, tailored to their individual needs and abilities. Additionally, our in-house physiotherapists play a crucial role in conducting personalized physiotherapy exercises, both one-on-one and in group sessions, to enhance mobility, flexibility, and overall physical function. This comprehensive approach ensures that our residents receive the specialized care they require, promoting their independence and improving their overall quality of life.

- **Sleep**

According to a recent study in the journal PLoS (Public Library of Science) Medicine, those over 50 years old who sleep less than five hours a night are more likely to acquire numerous chronic conditions like diabetes and cardiovascular diseases.

At **[Epoch](https://www.epocheldercare.com/)**, we recognize the importance of proper sleep for the well-being of our elderly residents. To address circadian rhythm disturbances, we actively engage them in a variety of activities and exercises within our facility. By providing a stimulating and fulfilling environment, we aim to promote a healthier sleep-wake cycle and improve their overall sleep quality. This approach not only enhances their physical and mental health but also contributes to a more vibrant and fulfilling lifestyle during their stay at our facility.

Besides the non-pharmacological approach, we adhere to the drug/insulin regimen as prescribed by the endocrinologist.

**To Sum Up**

Regular blood glucose monitoring, prescribed medications, balanced diet, physical activity, brain-stimulating activities, stress reduction, social interactions, and emotional support are vital in managing diabetes and dementia holistically. With this comprehensive approach and with proper treatment and guidance from specialists (like endocrinologists and neurologists), we can address physical, mental and emotional aspects, optimizing brain health, preventing complications, and improving the quality of life for individuals with these conditions.

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The Correlation Between Diabetes and Dementia: Unraveling the Intricate Connection

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Within the walls of this special place, I have found comfort and solace and a home away from home that has embraced me with open arms. It's a place that has become integral to my life's journey. In this blog, I have shared my thoughts and experiences about my journey with Epoch Elder Care, wherein I am currently the facility manager of **[Epoch Elder Care - Vermeer House, Gurugram](https://www.epocheldercare.com/our-homes/delhi-ncr)**. I have completed three splendid years at Epoch, and when I joined, I had limited knowledge **[about dementia](https://www.epocheldercare.com/about-dementia)**, Parkinson's, and **[assisted living](https://www.epocheldercare.com/assisted-living)**. Previously, I had heard about NGOs and elder care facilities so my initial thoughts were that it would be similar to working in an old age home, but I was nowhere close to the reality. 

Prior to working with **[Epoch](https://www.epocheldercare.com)**, I worked as a cardiac nurse in various multi-specialty hospitals based out of Delhi, where I dealt with patients in critical care units, Cathlab procedures, and emergency situations. It was a highly demanding job with long hours and a busy schedule. However, I often questioned the purpose of my work and the meaning of my life. I didn't find answers to these questions throughout my experience while working with the hospitals. 

I often felt a strong desire to do more for others. Although I became a nurse, I wanted to explore more possibilities of caring for others so I searched for other job opportunities and eventually came across **[Epoch Elder Care](https://www.epocheldercare.com)**. Initially, I thought it would be similar to the other  **[assisted living homes](https://www.epocheldercare.com/assisted-living)**. However, on my first day, I realized that I had a lot to learn about dementia care besides assisted living care as we focus on the person as much as their medical conditions. I am grateful to my team that supported me during the initial months and made my learning easier and now Epoch feels like my second home. 

The daily interactions with the elders, their smiles, and their happiness have become the highlight of my day. Being present in their lives brings me a profound sense of purpose and fulfillment. The elders often seek my advice and confide in me, sharing their thoughts and dreams. I feel honored to be there for them, to lend an empathetic ear and to offer all kinds of support with the help of the care staff members. In these precious exchanges, I realize the depth of the relationships we have built, and I am reminded of the profound trust they place in me.


I start my day by spending some quality time with elderly residents living with dementia and **[Parkinson’s](https://www.epocheldercare.com/parkinson-disease-care)**. One of the ways to connect with them is by holding their hand for a few good minutes, fostering a sense of comfort and companionship. By doing this I aim to create a sense of comfort and security, reducing stress and aggressive behaviors in them. Also, I assist them in taking a walk outdoors and indoor and helping them walk by providing support makes them feel secure, valued and cared for. These ways of communicating are considered effective when it is harder to communicate through words. Taking care of fall management is a crucial aspect of clinical care, especially for the **[elderly living with dementia](https://www.epocheldercare.com/epoch-dementia-care-program)** and **[Parkinson’s](https://www.epocheldercare.com/parkinson-disease-care)**. 


Managing dementia is a significant challenge, and it requires special care and understanding. Sometimes, words may not reach them, but a genuine smile can make a difference. Smile is one the most effective language they truly understand and by smiling while seeing them can bring a positive impact in their daily lives.

I always prioritize the happiness of our elderly residents. If I sense sadness in their eyes due to any reason, I don't ask why they are sad. Instead, I focus on responding in a way that brings them happiness, and residents reciprocate by giving me their warm smiles. 

I don't consider myself merely a facility manager of **[Epoch Vermeer House](https://www.epocheldercare.com/our-homes/delhi-ncr)**,  I see it as my second home, and I am taking care of my family members, residents of Epoch. The concept of a second home is truly wonderful because I no more feel a daily longing for my family. I celebrate every festival with the residents, blending the cultural and festive traditions of both North and South India. Whether it's Onam, a significant festival in Kerala, or any other festival, I create a sense of belonging for our elderly residents. We prepare Onam Sadya, engage in Onam dance, dress up in traditional attire, and adorn Onam Gajra together with all the residents. I find joy in celebrating festivals with my elderly residents who are now no less than my own family members and they also equally enjoy festivities and celebrations along with me and the care staff members at **[Epoch](https://www.epocheldercare.com)**. 

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Epoch - My Second Home 

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With the ongoing aging of our population, the number of **[elders with dementia](https://www.epocheldercare.com/epoch-dementia-care-program)** will also rise. Dementia refers to a neurological condition marked by a deterioration in cognitive functions, impacting memory, thinking capacity, behavior, and daily functioning. In the realm of caring for the elderly, it is vital to promote an understanding of dementia and the profound effects it has on individuals, families, and communities. This blog aims to shed light on the significance of **[dementia awareness in elderly care](https://www.epocheldercare.com/about-dementia)** and why it is critical for healthcare professionals, families, caregivers, and society as a whole.


#### **1. Early Detection and Diagnosis**

Dementia is a progressive condition, and early detection plays a pivotal role in managing its symptoms and providing appropriate care. Awareness initiatives can educate healthcare professionals, caregivers, and families about the **[early signs of dementia](https://www.epocheldercare.com/about-dementia)**, empowering them to recognize the symptoms and seek a timely diagnosis. Early detection allows for the implementation of interventions and treatments that can potentially slow down the progression of the disease, improve the quality of life for individuals living with dementia, and provide better support to their families.

#### **2. Person-Centered Care**

Dementia awareness encourages a concept of a person-centered approach to **[elderly care](https://www.epocheldercare.com)**. Understanding the unique needs, preferences, and challenges of individuals with dementia is essential for delivering personalized care that promotes their well-being. By increasing awareness, healthcare professionals and caregivers can develop strategies to effectively communicate, engage, and provide meaningful activities for those living with dementia. Person-centered care helps maintain dignity, independence, and a sense of purpose, fostering a better quality of life for individuals affected by the conditions. 

#### **3. Caregiver Support and Education**

Dementia often places a significant burden on caregivers, whether they are family members or healthcare professionals. Increased awareness helps provide support and resources to these caregivers, who play a vital role in the lives of individuals with dementia. Education programs, support groups, and respite care services can equip caregivers with the knowledge and skills needed to manage challenging behaviors, promote self-care, and navigate the emotional and practical aspects of caring for someone with dementia. By providing support and education, we can reduce caregiver stress, prevent burnout, and ensure better care outcomes.

#### **4. Reducing Stigma and Social Isolation**

Dementia awareness efforts help combat the stigma associated with the condition. Public education about dementia can dispel misconceptions and foster empathy and understanding in society. By creating a more inclusive and compassionate environment, we can reduce social isolation for individuals **[living with dementia](https://www.epocheldercare.com/epoch-dementia-care-program)** and their families. This, in turn, promotes their participation in community activities and preserves their social connections, which are vital for mental and emotional well-being.

#### **Summing Up!**

Dementia awareness in elderly care is not just about understanding the disease; it is about promoting empathy, providing person-centered care, and supporting individuals and their families on their dementia journey. At **[Epoch](https://www.epocheldercare.com)**, we have taken various initiatives to increase the awareness of dementia - through authored articles, webinars, talks in communities, participating in relevant conferences, encouraging volunteers to visit our **[Epoch homes](https://www.epocheldercare.com/our-homes)** etc.   

By increasing awareness, we can facilitate early detection, improve care practices, reduce stigma, and advocate for better policies and services. Healthcare professionals, caregivers, and society as a whole must recognize the critical importance of dementia awareness and work together to create a more dementia-friendly world.

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Why is Dementia Awareness in Elderly Care Critical?

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**_"Healthy aging is not just about avoiding diseases, but also about enjoying life and staying active, connected, and productive.”_**

The above statement is true and with some effort and dedication can be achieved by people who make significant efforts to walk on the path of healthy aging. I know many residents who are in their 60s or early 70s and have decided to lead a healthy life by channelizing their lifestyle. But how do we do it for those who are 75 and above? Elders with multiple comorbidities, especially chronic diseases like **[Dementia](https://www.epocheldercare.com/epoch-dementia-care-program)**, Parkinson's Disease etc. primarily affect one's personality or change them completely.  


Most of the time it's thought that there's nothing one can do for such elderly people, but I feel otherwise. Being a trained nurse and having spent most of my time in an [**elder care home**](https://www.epocheldercare.com/) for the past six and half years, especially those who have Dementia and **[Parkinson’s disease](https://www.epocheldercare.com/parkinson-disease-care)** is that they can be helped to have a life that leads to healthy aging. 

#### **Design a Meaningful Life by Adopting a Holistic Approach**

One of the critical factors is knowing your elderly loved ones as a person, what their past likes and dislikes were and what they enjoy doing. Their hobbies can help engage them in what they used to love doing; it may be gardening, singing songs, playing musical instruments, or reading but you need to know what that is, to help them relive the happy moments. 


A push, a word of encouragement and your active participation is what it takes. We have a resident who loves listening to songs and singing but her speech is affected, that doesn't stop her from singing or humming her favourite song when she hears it "Ae Dil Hai Mushkil" or moving her hands and dancing to the tunes of the music. 
 
One of the core aspects of healthy aging according to me is enjoying life to whatever extent possible besides being physically or cognitively healthy, even if you are living in **[assisted living homes](https://www.epocheldercare.com/assisted-living)**. As caregivers or family members, we just need to know what our elderly loved ones enjoy doing and do our bit to continue to create those happy moments in their lives by being with them to make their lives easy and happy. 

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Embracing the Art of Healthy Aging

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Do you know any inactive elderly who lack concentration? Do they struggle with normal memory recall?

**Let's gain a deeper understanding of the factors contributing to their situation.**

As we age, the cognitive abilities start to decrease. Problem-solving, processing speed, short-term working memory, memory and information retrieval, and attention problems are a few among these. A longitudinal study revealed that a cognitively active lifestyle that includes reading and information processing in old age may postpone the onset of dementia in Alzheimer's disease by as much as 5 years. 

Epoch understands this fact that dementia cannot be stopped, but progression from one stage to another can be slowed down by engaging the seniors in various activities. Cognitive exercises  for the elderly keeps them alert, thus reducing the risk or delaying the onset of **[age-related dementia](https://www.epocheldercare.com/epoch-dementia-care-program)**. Other main goals include enhancing quality of life by providing a sense of accomplishment, purpose, usefulness, or involvement; reducing agitation or wandering; enhancing a sense of self-worth and dignity; or fostering a sense of normalcy.

At **[Epoch Elder Care](https://www.epocheldercare.com/)**, we schedule various physical and cognitive activities for our residents as per the requirements of the stages, and each activity has its own defined purpose. All the activities are not applicable on all the elders as each one has had their own interests in the past.

There are many activities that are beneficial for the elderly to enhance their cognitive ability, which are as follows: 

#### **Drawing and Painting**

Engaging in creative activities stimulates the brain and aids in imagination activation. Dopamine levels in the brain have been found to increase during creative activities, making people feel happier overall. Encouraging the seniors to paint with water and pastel colors is a great choice for those with eye and hand coordination difficulties. This type of activity is a reflection of their emotion. 

#### **Playing Board Games**

An elderly individual with dementia may benefit from the mental stimulation provided by simple board games like Snake and Ladder or Checkers. They gain mental stimulation from the board games by fostering social engagement, problem-solving, and enhancing hand-eye coordination.

#### **Reading the Book Loudly**

A person may lose their ability to read due to certain **[types of dementia](https://www.epocheldercare.com/about-dementia)**. People with dementia who are unable to read for themselves can benefit when someone narrates or reads for them. It may be stories, articles, or anything else that they like to hear. Imagination is sparked in their brains by becoming a storyteller for them.

#### **Doing Crossword Puzzles**

The thoughts of your elderly loved ones can be kept occupied in a delightful way with puzzles. Like word jumbles and crossword puzzles, which train vocabulary expansion as well as memory and problem-solving skills. Word games Playing word games may help older adults' cognitive function, according to a recent study. Scrabble is an example of a competitive game that not only offers these advantages but also promotes social interaction. 

#### **Volunteering**

Engaging in volunteer work significantly improves the health and happiness of the elderly. The act of volunteering brings tremendous benefits to the overall wellness of senior citizens. The wellbeing of older adults experiences significant positive effects through their involvement in volunteer activities. Participating in volunteering has a profound impact on the physical and mental health of the elderly.

#### **Meaningful Conversation**

Conversation with others is one of the most crucial cognitive exercises for seniors. People frequently become more reclusive as they get older, which limits their opportunities to talk to others about the things that are important to them. You can engage their minds and uplift their spirits by asking them what they think about various scenarios and occurrences. 

##### **Conclusion**

These are some of the activities that we as caregivers can do to keep the elderly cognitively active. Not every elderly individual likes to participate in the activities, but we try to engage them when they are comfortable. At **[Epoch](https://www.epocheldercare.com/)**, we try to engage elderly in various activities during the daytime based on their interests, and when it seems that they are happy with it, we further offer them meaningful activities on a day-to-day basis. It is important to note that elderly may not be actively participating, but observing others is also cognitively stimulating.


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6 Activities to Boost the Cognitive Ability of the Elders

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India, renowned for its abundant cultural heritage and diverse traditions, has witnessed a remarkable rise in the number of senior citizens opting to live independently. While independence and self-reliance are admirable traits for individuals, this growing trend brings forth unique challenges for elderly individuals. **[At Epoch Homes](https://www.epocheldercare.com/our-homes)**, as we extend a warm welcome to senior citizens, we gain invaluable insights into the hardships they encounter while living alone. Drawing from my research and experience, the following are the key issues faced by senior citizens when residing independently. 

## Social Isolation and Loneliness:

One of the most significant challenges faced by senior citizens living alone is social isolation and loneliness. With the changing dynamics of modern society, families are increasingly becoming nuclear, and the traditional support systems are gradually diminishing. Elderly individuals often find themselves without regular social interactions, leading to feelings of loneliness and depression. 

## Health and Medical Care:

As individuals age, health issues become more prevalent, requiring regular medical attention and care. Senior citizens living alone often face difficulties in accessing healthcare services, managing chronic conditions, and adhering to medication regimens. Limited mobility and lack of assistance can exacerbate these challenges, and sometimes due to which they don’t get the adequate treatment on time which results in deterioration of the overall health. 

Fortunately now there are home healthcare services like Emoha and mobile medical units which can provide regular check-ups and ensure prompt medical attention. Educating seniors about the importance of regular health check-ups and preventive measures can empower them to take control of their well-being.

## Safety and Security:

Safety concerns pose another significant challenge for elderly individuals living alone. With rising crime rates and the vulnerability that comes with age, senior citizens are often targeted by fraudsters, burglars, and scam artists. This constant fear of safety can lead to heightened stress and anxiety. 

Many communities and local authorities can work together to enhance the safety measures for senior citizens living alone. Installing security cameras, and improving street lighting can create a safer environment. It is also important to educate senior citizens about common scams and frauds, enabling them to protect themselves and report any suspicious activities.

## Financial Stability:

Managing finances can be overwhelming for senior citizens living alone, especially if they are dependent on a fixed income or retirement savings. Rising costs of living, inflation, and lack of financial literacy can pose significant challenges in meeting day-to-day expenses and planning for the future.

Providing financial counseling and assistance to senior citizens can empower them to make informed decisions about their finances. Introducing government schemes and pension plans targeted specifically for the elderly can offer financial security. Moreover, conducting workshops and awareness programs on financial management can enhance their financial literacy and enable them to secure their future. 

## To Sum Up

The challenges faced by senior citizens living alone in India are real and demand our attention. It is imperative for society, government agencies, and individuals to come together and address these issues. By promoting social inclusion, improving access to healthcare, ensuring safety, and providing financial support, we can create a supportive environment that allows our senior citizens to lead dignified and fulfilling lives in their golden years. 

Encouraging community involvement and social engagement is crucial. Local community centers, senior citizen groups, and NGOs can organize events and activities to bring seniors together, fostering a sense of belonging and companionship. In this context **[Epoch](https://www.epocheldercare.com/)** has also started the initiative of spreading awareness on **[dementia to help the elders](https://www.epocheldercare.com/about-dementia)** to seek help as they understand the symptoms. Furthermore, promoting intergenerational interactions can create meaningful connections and combat social isolation.

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Challenges Faced by Senior Citizens in India while Living Alone

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