Dr Karthiyayini Mahadevan, Head, Wellness and Well-being, Columbia Pacific Communities emphasises on the importance of geriatric care and why it should become a part of primary healthcare services
According to the Census of India, the number of senior citizens was approximately 7.6 crore in 2001. The number increased to 10.4 crore in 2011 and is expected to grow to 17.3 crore by 2025 and 24 crore by 2050. In the last two decades, there has been a significant increase in the number of elderly persons, who amount to over 8 per cent of the population in India today. Due to the availability of better healthcare services, this demographic transition is on the rise.
The withering away of joint family has resulted in an unintended and unfortunate consequence – the slow neglect of the elderly. There is a pressing need to pay attention to the well-being of the elderly. Diseases and disorders such as Alzheimer’s, Parkinson’s and dementia are on the rise. With changing lifestyles, prevalent in the western world are fast emerging in India. However, there is a lot to be desired when it comes to the infrastructure and support system for seniors in our country.
With the rising income levels, a growing number of senior citizens are economically independent and willing to pay for facilities and services. Hence there has been a spurt in the retirement home facilities offered in the country. On the other hand, the recent statistics by the Indian Journal of Community Medicine reveals that 75 per cent of the elderly population is living in rural areas. About 48 per cent of the elderly population is women, of which 55 per cent are widows. A total of 73 per cent of elderly persons are illiterate and dependent on physical labour for a living. One-third of the elderly population is reported to be living below the poverty line. 66 per cent of older persons is in a vulnerable situation without adequate food, clothing, or shelter. About 90 per cent of the elderly are from the unorganised sector, i.e., they have no regular source of income.
To cater to the needs of the elderly from the two ends of this spectrum, there is a need for the introduction of a geriatric master health check up including the biochemical markers of organ function and screening for mental health. Living alone, out of choice or otherwise, leaves them lonely when they age. It is imperative that retirement homes have regular counselling sessions to help them come out of their depression.
At present, most of the geriatric outpatient department (OPD) services are available at tertiary care hospitals. Also, government facilities such as daycare centres, old age residential homes, counselling and recreational facilities are urban-based. Since a very large percentage of the elderly reside in rural areas, it is imperative that geriatric healthcare services be made a part of the primary healthcare services. This then necessitates the need for specialised training of medical officers in geriatric medicine. Peripheral health workers and community health volunteers should also be trained to identify and refer elderly patients for timely treatment.
The Central and State governments have already made efforts to tackle the problem of economic insecurity by launching policies such as the National Policy on Older Persons, National Old Age Pension Programme, Annapurna Programme, etc. However, the benefits of these programmes have been questioned several times in terms of the meagre budget, improper identification of beneficiaries, lengthy procedures and irregular payment.
A three-pronged approach to take care of the elderly
- As we grow old, we end up exhausting our thinking faculty or become too emotional or too impulsive in actions. Growing old is a result of this one-sidedness. Ageing gracefully comes with balance. So, it’s important to use a three-pronged approach to take care of the elderly.
- Care for their physical movement through regular stretches, games. The willing realm of the elderly is moved through yoga, Tai-Chi, dance.
- Nourish their feeling realm by organising movie-screenings, entertainment programmes, music concerts and chanting sessions.Their thinking realm is taken care of through group discussions about various topics, connecting with the youth through debates, reaching out to children in the nearby government schools for teaching language and mathematics, conduct summer camps for the housekeeping staff’s children in our communities to facilitate interaction between the elders and children.
When we reach 60 years of age, we embark on our second childhood. Climbing up the ladder of life should be a joyful experience and one that’s not ridden with boredom.
It is time that we spread awareness about caring for the elderly. It is not just the government’s responsibility but also of a community as a whole. Specialised geriatric care needs research and progress like any other discipline in the health care sector.