AGING is both a blessing and a challenge. It can be a blessing when it leads a family to experience the joy of living with an older person. Healthy aging brings about joy and peace. It can be a challenge when it leads to the depletion of family earnings, and leaves it in perennial hardship.

In any case, each family is duty-bound to care for its members in whatever situation they find themselves in, including sharing the wealth the family is endowed with or a meagre income it relies on.

A family blessing includes getting the wisdom a healthy older person has accumulated over the years, but a family with an ailing older person may experience burdensome duties and in some cases family members may wish nature took its course. This may happen if “extraordinary means”, which include prolonged artificial care without which a patient may lapse into a vegetative state, are involved in keeping an ailing older person alive.

From a moral point of view, when a patient with poor prognosis is looked after and “extraordinary means” are applied to keep him or her alive they may not impose the moral duty to persons taking care of him or her as “ordinary means” do. “Ordinary means” include normal medical care, and feeding which people everywhere are duty-bound to provide to a patient.

One of the challenges is when an older person is suffering from one or more non-communicable diseases (NCDs), whose treatment is costly and can condition family members to live in hardship during the lifetime and after the older person passes on.

While it shouldn’t be a curse to live with an ailing older person (since any young person is a potential older person), it is important to ensure older persons keep themselves healthy through physical activity and eating a balanced diet (healthy diet). When this is done and still an older person becomes ill, adequate ordinary care should be applied. However, where there is positive prognosis “extraordinary means” may lead to recovery. So, a prognosis should be established for the family to decide to apply ordinary or extraordinary means to save the life of an ailing family member.

Thus, there is a way of living healthy and dying in peace when nature takes its course. An older person can engage in daily physical activity, which includes daily household chores around the house, farming, fishing, walking, cycling, dancing, and physical exercises, as opposed to a sedentary lifestyle/behaviour (like spending too much time sitting, watching a TV, working in an office or just staying idle). In all this, good planning and adhering to is needed.

Mainland Tanzania Food-Based Dietary Guidelines for a Healthy Population: Technical Recommendations (Tanzania FBDG Manual, 2023) defines an NDC as: “A medical condition or disease that is not caused by infectious agents (non-infectious or non-transmissible). NCDs can refer to chronic diseases that last for long periods of time and progress slowly and result from a combination of genetic, physiological, environmental, behavioural and dietary factors.”

According to the manual, NCDs refer to cardiovascular disease, diabetes and cancer and their risk factors are “raised blood pressure, raised blood sugar and overweight. In addition, physical activity is a key determinant of energy expenditure and thus is fundamental to energy balance and weight control.”

Physical exercise, the manual says, “is a type of physical activity that is planned, structured, repetitive and purposeful to maintain or improve one’s physical fitness.” The manual outlines the following as examples of physical exercise a person may do daily: 1) aerobic activity (walking, dancing, swimming, riding a bicycle), 2) strength (anaerobic) exercises (push-ups, squats, pull-ups), 3) flexibility exercises – range of motion (yoga, stretching), and 4) functional balance exercises (standing with one leg, muscle strength exercise).

Citing a study conducted by World Health Organisation (WHO) in 2009, the manual says physical inactivity (sedentary lifestyle/behavour) is estimated to be the main cause of about 21–25 per cent of breast and colon cancer, 27 per cent of diabetes and 30 per cent of ischemic heart disease.

It stresses that doing physical activity removes between 6 per cent and 10 per cent of the major NCDs of coronary heart diseases, type-2 diabetes, breast cancer and colon cancer, while increasing life expectancy (longevity). Sustainable development goal (SDG) 3 Target 3.4 states: “By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and wellbeing.”

The manual says a WHO study conducted in 2020 recommends the following physical activities for older persons aged 65 years and above: doing at least 150 minutes of moderate intensity aerobic physical activity throughout the week or doing at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week, or an equivalent combination of moderate and vigorous-intensity activity.

“For additional health benefits, older persons aged 65 years and above should increase their moderate-intensity aerobic physical activity to 300 minutes per week or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate and vigorous intensity activity.”

Many people, including older persons themselves, think physical exercises are for young people only. Yet, the manual highlights physical exercises for different age groups such as infants (0–12 months), toddlers (1–2 years), pre-primary schoolchildren (3–4 years), children (5–17 years), young people and adults (18–64 years), and older persons (65 years old and above).

The manual also recommends physical activity for pregnant and breastfeeding mothers/women. With this group, it recommends doing at least 150 minutes of weekly moderate intensity, while keeping active daily. It says physical activity can include walking or performing daily household chores.

However, it cautions pregnant mothers/women against vigorously intense exercises. Instead, it recommends consulting their medical attendants for confirmation to prevent health risks associated with their pregnancy and breastfeeding condition. Sustainable development goal (SDG) 3 states: “Ensure healthy lives and promote wellbeing for all at all ages.”