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Healthcare for the elderly

Healthcare for the elderly

A 'senior citizen' is a citizen of India who is of age sixty or older. Population Census 2011 revealed that there are nearly 104 million elderly persons in India; 53 million females and 51 million males. A report released by the United Nations Population Fund and HelpAge India suggests that the number of elderly persons is expected to grow to 173 million by 2026. Both the share and size of the elderly population is increasing over time.

From 5.6 per cent in 1961 the proportion has increased to 8.6 per cent in 2011. Out of this 71 per cent of the elderly population resides in the rural areas while 29 per cent is in urban areas. In rural areas, 66 per cent of elderly men and 28 per cent of elderly women were working, while in urban areas only 46 per cent of elderly men and about 11 per cent of elderly women were working. In the age group of 60-64 years, 76 per cent persons were married while 22 per cent were widowed. The remaining 2 per cent were either never married or divorced.
This period of life is full of challenges. With growing age, physical capacities are reduced. Mental faculties too, begin a downward trend. A person becomes vulnerable to a plethora of diseases. Most of these diseases are degenerative in nature and chronic in type. The list of the risks of old age, including the illnesses, disorders, ailments, maladies, and diseases associated with it is indeed quite long. Through various researches around 125 diseases have been identified to be directly connected with this age group, some of the important and more challenging illnesses need to be taken care of on a priority basis. Diseases affecting the heart, chest and nervous system are the most common.
Arthritis is another very common condition that ageing people suffer from. It may be fatal in a few cases because of the complications arising out of this but the declining quality of life seriously affects both the physical and mental status of a person.
Heart diseases are the leading killers of persons above the age of 65. One must get the heart monitored at regular intervals to identify the occurrence of any disease well before it becomes irreparable. This needs awareness and has financial implications as well.
Cancer is the second leading cause of death. This incapacitates the person, who has to pay repeated hospital visits requiring expensive investigations, along with regular monitoring and medical or surgical intervention across long periods of time. All this takes a serious toll on the economy and psychology of a person. The whole family has to undergo extreme stress. Depression is one of the serious issues that are associated with it.
Respiratory diseases are the third common cause of death among elderly who are more vulnerable to pneumonia and other infections. Many of them in this age group develop chronic, obstructive pulmonary disease which requires repeated hospitalisation and intensive treatment.
Cerebrovascular accidents occur as a result of leakage or clotting of blood in brain or tumours in the cranium. A person may develop paralysis. The quality of life severely deteriorates and the patient becomes dependent on others. This becomes a cause of serious psychological disturbance and a matter of stress for the whole family.
Parkinsonism hampers a person's capabilities and gradually cripples the physical capacities. Alzheimer's disease occurs because of degenerative processes of the brain. The patient develops cognitive impairment and becomes unable to take care of themselves. They become a concern for the family as the disease is chronic. Osteoporosis makes bones brittle and the person is more likely to incur a fracture on any of their bones. But the vertebral bodies fracture leading to their collapse can cripple the patient. Falls are more common and these are emergency conditions which may lead to fractures and hospitalisation.
Diabetes is on the rise in our country. Those who had diabetes at an early age develop several complications by the time they step into old age. Complications may be related to the nervous system, heart, kidney, muscles and other body systems. Infections occur more commonly in this age group because of a low resistance power. Sometimes these may prove to be fatal.
Depression is an increasing problem in our country, which is occurring as a result of changing family relations, increase in the cost of healthcare, physical incapacities that increase with age and a person's dependence on his siblings. Losing one's life partner causes loneliness and isolation leading to depression.
Poverty affects senior citizens' health. Older women are slightly more likely than men to be living in poverty, and that gap widens in those over 80. Single older adults are also significantly more likely to live alone with fewer resources.
Old age is a challenging period in one's life. It is not easy to accept that one now must be dependent on their children for many everyday needs. Financial deprivation further adds to the difficulties. The situation gets worse if the family is uncaring and neglects the elderly who they should be caring for. In our country where the social security net is very poor, the elderly face great difficulties as far as healthcare is concerned. To ameliorate the situation several steps have to be taken. The elderly need compassion. They need
emergency care - sometimes repeatedly. Health care of the elderly has to be designed accordingly.
(Dr. Arun Mitra is an ENT specialist based in Ludhiana. Views expressed are strictly personal.)

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