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The case for geriatric care in India

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On International Day of Older Persons, Meena Ganesh, Co- Founder and Chairperson, Portea Medical explains that there is a need for timely initiatives by stakeholders across the spectrum in the form of strategies that can bring about improvements in elderly care operations and their quality of life

There is a demographic transition in India. By the year 2050, it is expected that the number of elderly in the country would reach 324 million. We are now an ageing country and the factors responsible for this include decreasing fertility and mortality rates as an outcome of better health care services. While a lot of focus has been placed on all aspects ranging from maternal and child health to control of infectious and non-communicable diseases, elderly care in India continues to face medical, social, and economic challenges – in particular, healthcare. On International Day of Older Persons, there is a need for timely initiatives by stakeholders across the spectrum in the form of strategies that can bring about improvements in elderly care operations and their quality of life.

The challenges

The healthcare challenges faced by elderly in India revolved around both communicable and non-communicable diseases. Apart from age-related issues such as loss of sensory functions they are also susceptible to chronic conditions such as hypertension, coronary heart disease, and cancer. Estimates by the government indicate that cardiovascular diseases account for one-third of the mortality among this segment. There are also conditions like Alzheimer’s, all of which limit even their daily activities. This is exacerbated by factors such as breakdown of family support systems and decreased economic independence. Although there are various government initiatives in place, the benefits are yet to reach the larger segment.

The way forward

Given the urgent need to bring about an improvement in the quality of life of the elderly across various aspects, there are several things that a public-private partnership can address.

Making geriatric care services a part of primary care

Currently, geriatric services are available in tertiary care hospitals. Most facilities are based in urban areas. In a study, it was found that about 46.3 per cent of the participants were unaware of any geriatric services near their homes. Given how a majority of the elderly stay in the rural region of India, it is important to integrate geriatric care into primary healthcare services. It is also important to mobilise health workers and community volunteers who can identify and refer the elderly for timely care. Caregivers can play a very empowering role in this regard. There are also companies that offer services such as on-premise and at-home screening for various conditions.

Need-based care

Healthcare services should be based on the needs of the elderly. Currently, more importance is given to rehabilitation versus prevention. There is a need for strategies that focus on timely diagnosis of chronic condition. There are several home healthcare startups today which are enabling this in the comfort of homes. A multi-pronged intervention programme that is viable and can be easily monitored can come as a solution. Prevention should also address aspects like awareness about health conditions, good nutrition and balanced diet, and exercise. There should also be efforts towards promoting a positive mindset through well-being activities.

Creating a community of geriatric health workers

Another dimension of providing access to care for elderly involves capacity building of health personnel in different segments. Community geriatric healthcare workers can play a big role in providing care to elderly population at home. Currently, geriatric caregivers provide need-based care. But this approach can extend to a larger level to provide care for communities provided there are relevant public-private partnerships in place. Community leaders can play a huge role in identifying their needs and addressing them.

Geriatric words in hospitals

While this is becoming a reality, there is still a need to take the concept across all tertiary care institutions. There should be a multidisciplinary team in place which is specifically trained to address the needs of this segment – including specialists trained in geriatric care. Emphasis needs to be provided to geriatric medicine at the undergraduate level, not just as a subsidiary subject but in mainstream.

Final word

We are facing a future where the number of elderly in the country is likely to be more than the number of institutions that can take care of them. Given the change in societal structures and aspirations, a holistic approach is the need of the hour. Caring for the elderly is not just about addressing their health challenges but improving the overall quality of their life through concerted efforts by the healthcare and healthtech sectors with support from the government.

 

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