Caring for the elderly
In a country where the social security net is poor, designing appropriate healthcare for senior citizens is a huge challenge
Economic developments and technological innovations have helped increase life expectancy worldwide. There was a time when thousands would perish because of epidemics like plague and smallpox which had an adverse effect on life expectancy. Such deadly diseases are under control now. Life expectancy in India was 32 years at the time of independence in 1947. In 1969 it rose to 47 years further growing to 60 years in 1994 and 69 years in 2019. India's population grew at an average annual rate of 1.2 per cent between 2010 and 2019 to 1.36 billion, more than double the annual growth rate of China, according to a report by the United Nations Population Fund. The number of young people in our country increased at a rapid rate and the number of elderly also grew steadily.
According to the law, a "senior citizen" means any person being a citizen of India, who has attained the age of 60 years or above. Population Census 2011 revealed that there are nearly 104 million elderly persons (aged 60 years or above) in India; 53 million females and 51 million males. A report released by the United Nations Population Fund and Help Age India suggests that the number of elderly persons is expected to grow to 173 million by 2026. From 5.6 per cent in 1961, the proportion of the elderly increased up to 8.6 per cent in 2011. (Source: Elderly in India 2016)
An elderly person has to face manifold challenges, including physical, mental, emotional, social and financial. They are always worried about social security. As one grows, both the physical and mental faculties face a downward trend. The person is more prone to fall prey to various types of diseases. Most of these diseases are of degenerative nature and thus are of chronic nature. List of risks including illnesses, disorders, ailments, maladies, and diseases associated with old age are quite long. Through various researches around 125 diseases have been identified to be directly connected with this age group.
Arthritis is a very common condition leading to pain in the joints and lowering the quality of life by prohibiting day to day activity and movements of the person. It may be fatal in a little number of cases.
Heart Diseases are the leading killers of persons above the age of 65. An elderly person needs to get his heart monitored time to time to get to know any disease cropping up well on time. This needs awareness and has financial implications as well.
Cancer is the second leading cause of death. The person has to pay repeated hospital visits requiring expensive investigations, monitoring and medical or surgical intervention for a long period of time. All this seriously affects the economy of the whole family and psychology of the patient. Depression is one of serious issue associated with it.
Respiratory Diseases are the third common cause of death among the elderly who are more vulnerable to pneumonia and other infections. Many of them in this age group develop Chronic Obstructive Pulmonary Disease (COPD) which requires repeated hospitalisation and intensive treatment.
Cerebrovascular accidents occur as a result of leakage or clotting of blood in the brain or tumours in the cranium. A person may develop paralysis. His quality of life becomes very poor and he becomes dependent on others. This becomes a cause of serious psychological disturbance and a matter of stress for the whole family.
Parkinsonism hampers the person's capabilities and gradually cripples the physical capacities.
Alzheimer's disease occurs because of the degenerative process of the brain. The patient develops cognitive impairment and is unable to take care of himself. He is a concern to the family for safety and cost involved in his care.
Osteoporosis makes bones brittle and the person is more likely to develop fracture of any bone. The fracture of vertebral bodies can cripple the patient. Falls are more common and these are an emergency condition, which requires hospitalisation.
Incidence of Diabetes is increasing in our country. Those who had developed Diabetes in early age develop several complications by the time they reach elderly 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 the lowering of immunity in this age group. 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 which increase with the age and 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 years. Single older adults are also significantly more likely to live alone with fewer resources.
Elderly age group is a challenging period in one's life. Feeling of dependence on children for many day-to-day needs is difficult to accept. Financial deprivation adds up to the difficulties. The situation gets worse if the family is uncaring and neglecting the elderly. In our country where the social security net is very poor, elderly people face great difficulties as far as healthcare is concerned. To ameliorate the situation several steps have to be taken. Elderly need compassion. They need emergency care – sometimes repeatedly. Health care of the elderly has to be designed accordingly.
(The views expressed are strictly personal)