Health Needs of the Elderly

Development of health care facilities in the India and irradiation of several fatal diseases has meant that longetivity in the country has gone up substantially. India has witnessed significant developments in the spear of healthcare as life expectancy at birth has risen from 32 years in 1947 to 69 years (2019) and the National Health Policy 2017 aims to further raise it to 70 by the year 2025. As of now India’s demography is youthful yet this is set to change dramatically in the coming decades.

Himanshu Rath who is the Chairman of Agewell Foundation, an NGO working for the elderly explains how India’s elderly population is growing fast “There are about 130 million elderly in the country, every single day 17,000 people turn 60 and out of the total who die every day about 6500 are 60 plus, so around 10,500 people are being added into the elderly population every day. Already close to 10 per cent of our population is in the elderly bracket. Currently China has the world’s largest elderly population, the rate at which we are going we are likely to surpass them very soon, and if the trend sustains, we would remain at the top for the coming 60 years.”

Dr GS Grewal who is a Senior Consultant, Elder Care at Fortis Okhla, New Delhi points out that there is a visible trend of higher growth of women elderly population in the country “5 per cent of our population was in the elderly bracket in 1991, this has risen to 9 per cent in the 2011 census. On an average those above 67 years survive for 10 years, males survive on an average for 8 years and women on an average survive for 12 years, so what we are also witnessing is a feminisation of our elderly population.”

While old age brings with it an array of health problems psychological problems amongst the elderly seem to be rising “older people invariably harbor one or more non-communicable diseases like diabetes mellitus, hypertension, heart diseases, stroke, cancer and chronic lung diseases. In addition to this mental health problems such as depression, anxiety and dementia are common in old age. Stress coupled with an increase in loneliness and fast changing society are some of the major reasons behind these psychological problems. Many are not able to effectively cope with ageing, illness and loss of near and dear ones, adopting to change can also be challenging. Breakdown of family structure, thinning of emotional bonds also enhances stress.” says Dr Avinash Chakrawarty, Assistant Professor at the Department of Geriatric Medicine, AIIMS Delhi.   

Dr Chakrawarty warns that the elderly should not neglect their health problems “Generally it is seen that the older people think their medical illness as part of ageing process and they ignore their problems. Early detection of disease is always better as that gives the doctors a chance to check its progression.”

There exists a need to properly prepare for old age and people should not hesitate to consult experts “As one ages one should take some conscious decisions like avoiding isolation, regulating food intake is crucial; one should consume more of easy to digest food items. Food of the elderly should consist more of natural products that are rich in antioxidants and Vitamin C which boost immunity.  The elderly should also be counseled about specific measures to prevent falls etc.”

Reminding that old age would happen to everyone he says that one should not be afraid of it but make proper lifestyle choices to lower the chances of diseases “Vaccination against pneumonia and flu is an important preventive measure against common lung infections among older people. Numerous epidemiological studies have shown that interventions or preventive measures in lifestyle like smoking cessation, balanced diet, regular physical and mental activity can decrease the risk of disease development and increase longevity.”

Financial hardships one faces in old age has a bearing on people’s health as they are not able to meet their medical expenses “65% of the elderly are dependent on others for meeting their day to day requirements. This dependency makes them vulnerable to exploitation and unable to meet their medical expenses” says Himanshu Rath.

He highlights that even the affluent are not immune to dependency on their children “Even those who have made adequate savings for the old age or are well off significant percentage among them depend on their children to manage their finances hence they are also vulnerable to exploitation.”

One of the most painful experience of old age is the emotional trauma one has to endure “After a certain age when the body becomes infirm and dysfunctional one has to depend totally on others even for going to the toilet. This dependency causes emotional trauma to both the care giver and the one receiving it. If the caregiver is giving care willingly then trauma is a little less but if he is giving it unwillingly or is unable to give care then it becomes manifold. Emotional trauma is a big part of old age.”  says Rath.

Loneliness and certain social issues compound the problems of the elderly. “It is observed that older persons in the category of 60-70 years are looked after well by their children, but with further advancement in their  age, children find it difficult or are unable to look after them primarily due to their own advancing age and ever- increasing responsibilities towards their own children, etc. Majority of elderly in the 70 plus bracket face isolation and loneliness with many of them living in inhuman circumstances.”

Dr Grewal also echoes a similar sentiment “today more than disease it is the quality of life and dignity that is the problem; WHO has identified 8 social factors affecting quality of life and health of elders. Loneliness is a major problem it is a disease in itself. Government of UK has even appointed a Minister of Loneliness last year to look into this problem.”

The need of the hour is to ensure that more elder centric health programmes and health infrastructure is made available to cater to the requirements of the elderly however the requirements of the elderly don’t seem to be the priority for the government “Healthcare policy of our government is chiefly centered around women and child health development which of course is very important but we need to change track fast and address the problems of the elderly as well. World Health Organisation (WHO) estimates that by 2050 there would be more people in the elderly category compared to the under 15 category” says Dr Grewal. 

Dr Grewal who is a also the Chairperson of ‘Wellness Health & You’ NGO further explained the absence of elder centric health policies in India “Those in the 65 and above category require a fresh shots for pneumonia, Hepatitis B, chicken Pox and yearly shots of Flu prevention but we in India have no such program, the elderly hardly find a place in our health budget.”

Dr Chakrawarty feels that mobile health clinics could be particularly helpful for conducting comprehensive geriatric assessment of the older people but these have their limitations “through mobile health clinics can cater to a large population by providing them basic medical facilities at their doorstep, older people need multidisciplinary medical intervention that cannot be served by mobile health clinics. Through mobile health clinics we can do comprehensive geriatric assessment of the older people and identify most of their health issues but some problems need more aggressive management, multidisciplinary intervention.”