Being a widow, and with all her four daughters married, she has learnt to live life on her own. Whether going out to enjoy a sunny day or to a hospital for treatment, there is nobody to take care of her except God, she says.
“I have learn to live alone. I use to sit and wait in queues for medicine or for appointment with doctor. Though it is tiring but I had no option. Despite separate queues for elderly, it gets difficult at times,” said Maya Devi.
Diagnosed with Tuberculosis a while back, even her immune system has betrayed her. For quite sometime, her life has succumbed to the hospital bed. She is getting treated at All India Institute of Medical Sciences (AIIMS), in a well developed geriatric ward, supposedly the only one in the city.
Though our Prime Minister Narendra Modi banks on the young population to take the country on high road, the fact is by 2050 India would have 324 million populace above 60 years of age. The current aged populace, which is estimated to be around 83 million, one third live below poverty line and 75 per cent reside in rural areas, further limiting their access to healthcare facilities.
“Despite a countrywide alarm, geriatrics is still an alien field in our country. The concept of geriatric
usefulness has not yet set in our country. Also, there is negligence towards this field from medical professionals too,” said Anupama Datta, Director of Policy Research and Development, HelpAge India.
Although there are government and social policies for elderly in India, but geriatrics is relatively a new field of medicine.
“Post graduation in Geriatrics was introduced in 2011. They are not many seats reserved for this course. In main centres, there are nine seats, out of which four are in AIIMS, three in Madras medical college, one in medical institute in Kochi and Vellore respectively," said A B Dey, professor and head of department of geriatrics at AIIMS.
Geriatrics or geriatric medicine is a specialty that focuses on healthcare of elderly people. It differs from standard medicine as it focuses on unique needs of elderly and especially, managing multiple morbidities.
“Body of the elderly is different physiologically than young. Generally, they have multiple morbidities. They may simultaneously have osteoarthritis, depression, visual impairment, nutritional deficiency and such. In absence of geriatric care, an elderly person has to go to different specialist for treating their various ailments. Also, at the age of 60 and above, the patient doesn’t have the energy to run to different specialist. In geriatrics, the aim is to give comprehensive health care to elderly and help in healthy ageing,” said A B Dey.
If trends are to be noted, not many young aspiring doctors wants to opt for geriatrics. “Not many young doctors are interested in pursuing this course because many have misconceptions that it is not a proper medical field. Every doctor wants to become a surgeon,” said Dey.
Some who opt for it, say they are into this field by ‘chance.’ “Geriatrics was not my first choice. Since, I did not have many options, so I opted for it. I had doubts about the course but now I think I accidentally got the right thing. In this field, workload is less, elderly want to be heard more than cured,” said a geriatric resident at AIIMS.
The most recent policy effort is the National Policy for Health Care of the Elderly (NPHCE), released in 2011. As per the policy, eight super speciality institutions catering to development of geriatrics would be developed in different regions. The programme also included provision of establishing 10 bedded geriatric wards and dedicated Out Patient Department (OPDs) in 100 districts covering 21 states/UTs.
“City hospitals have geriatric clinics which are operational on particular days and also, preference to elderly is given. In our hospital, there is no specific geriatric ward. We have 100 bedded hospital in which around 20 beds are allocated for specialities. So, it is difficult to set up a geriatric ward. But we do witness many elderly seeking treatment,” said S K Sharma, medical superintendent at Aruna Asaf Ali Government Hospital.
Even if geriatric wards are established in district hospitals, another challenge that lies ahead is accessibility and awareness. “I visited a geriatric ward in one of the hospitals in Rajasthan. Most elderly complained that it was not useful for them. People are unaware of what is geriatric or why it’s needed for them. Most elders live with the attitude that at old age, they are bound to suffer with diseases that do not have any cure. With old age comes a negative connotation in our society,” said
‘Besides awareness, public facilities are cumbersome. Elderly often are unable to access it. Especially, elderly women from lower income group are more prone to it. Elder abuse is on rise but actions are far and few’, she added.
While government healthcare sector is lacking behind in geriatric care services, even the private sector has not shown much interest in the field. “There is no expressed demand. There is no trained manpower in the field or scientific assessment of its need. There is biasness towards young people. Even if private sector opens geriatric wards, how many will be able to access them?,” said Datta.
According to recent data, visual impairment and vision loss increases dramatically with age. Overall 10 per cent of India’s elderly suffers from depression; 50 per cent require psychological interventions at some point. “Because of weak immune system there chances of reoccurrence of diseases like tuberculosis and such. Many people also develop TB at this age. Dementia, chronic obstructive airways diseases, hypertension, heart diseases, diabetes are some of the common diseases that elders suffer from,” said a doctor at AIIMS.
AIIMS, which has a separate geriatric ward, caters to 150 patients on daily basis. “The hospital alone cannot be expected to take the load. Pressure has to be built at state and community level.
Government needs to prioritise elderly issues. They should also be given employment so they can
contribute to the overall GDP of the country,” said Anupama Datta.