ELDERLY CARE IN INDIA-CHANGING PERSPECTIVES

1
ELDERLY CARE IN INDIA-CHANGING PERSPECTIVES

• DR. K.L.SHARMA
• INDIAN GERONTOLOGICAL ASSOCIATION, INDIA

2
TRADITION SPEAK

• One who always serves and respects elderly is
  blessed with four things Long Life, Wisdom,
  Fame and Power
• Manusmriti Chapter 2121

3
Worldwide Trend of Population of 60 Years and
Above 1980-2020
1980 1990 2000 2010 2020
World 381.2 484.7 608.7 754.2 1011.6
Developed 173.3 203.6 234.6 232.4 308.2
Developing 207.9 281.8 374.1 491.8 703.4
Africa 23.4 30.9 41.8 57 82
Latin America 23.4 31.7 41.9 56.4 80.7
Asia (excl. Japan) 160 218.2 290 377.7 539.9
China 78.6 101.2 131.7 167.9 238.9
India 44.6 60.2 81.4 107 149.7
United Nations,World Demographic Estimate and
Projections
4
Proportion of Aged 60 and Over Population (in Per
cent) 
1980 1990 2000 2010 2020
World 8.6 9.2 9.9 10.8 12.9
Developed 15.2 16.8 18.4 19.7 22.4
Developing 6.3 7 7.7 8.7 10.9
Africa 4.9 4.8 4.8 4.9 5.6
Latin America 6.5 7 7.7 8.8 11
Asia (excl. Japan) 6.5 7.4 8.5 9.8 12.8
China 7.4 9 10.5 12.4 16.6
India 6.5 7.3 8.4 9.9 12.6
United Nations,World Demographic Estimate and
Projections
5
Elderly Population-Facts!

• Aging of population is an end product of
  demographic transition.
• The number of elderly people in developing
  countries is almost 3-4 times of that of
  developed countries.
• The developed countries have already experienced
  the consequences of this transition.

6
Elderly Population-Facts!

• World population of 6.1 billion at the dawn of
  21st century is likely to become 9.3 billion in
  2050 (UN 2004).
• Global aged population from 595 million to 2
  billion a four fold rise-by 2050!
• In terms of proportion -10 in 2000, 15 by 2025,
  rising to 21.6 by 2050.

7
Elderly Population-Facts!

• 73 of deaths in the elderly are related to
  heart diseases, smoking and cancers.
• 20 of doctors visits, 30 of hospital days and
  50 of bedridden days are ascribed to elderly
  patients.
• Expansion of morbidity even though increased
  life expectancy due to chronic non-communicable
  diseases.

8
Elderly in India -Facts!

• 24 million in 1961 increased to 77 million in
  2001
• Projected to rise to 179 million in 2031 and 301
  million in 2051.
• 70 and above projected to increase from 29
  million in 2001 to 132 million in 2051.
• 80 would be fastest to grow 8 million in 2001
  to 32 million in 2051.

9
Elderly in India -Facts!

• 2nd largest elderly (60) population in the world
  (2001)
• 80 are in rural areas
• 40 are below poverty line
• over 73 per cent are illiterate.
• about 90 of the old people have no official
  social security (i.e., without PF, Gratuity and
  Pension etc).

10
Elderly in India -Facts!

• Life expectancy 31.7 years in 1941 increased to
  60.5 years in 2000.
• 55 of the women of 60 years and above are
  widows.
• Older women most vulnerable.
• Elderly poverty is a major risk of ageing in
  developing countries.

11
Not just the numbers

• Family structure is changing to nuclear/small
  unit families.
• Without the safe, secure and dignified status in
  the family, the elderly are finding themselves
  vulnerable.
• Welfare of the elderly has been a low priority
  with the state

12
Distribution of Aged Persons by State of Economic
Dependence (n1000)
    Not Dependant Partially Dependant Fully Dependant No Response
Rural        
Male 485 180 313 22
Female 121 146 706 27
Urban        
Male 515 169 297 19
Female 115 110 757 18
National Sample Survey 52nd Round Survey, 1995-96
13
Distribution of  Care Provider of Economically
Dependent Aged
    Spouse   Own Children Grand Children Others  
Rural        
Male 113 766 50 71
Female 159 717 52 72
Urban        
Male 105 792 54 49
Female 182 695 56 67
National Sample Survey 52nd Round Survey, 1995-96
14
The Support

• The major thrust has been on improving the health
  status of children and women
• Geriatric services are largely unorganized.
• There are 186 old age homes, 233 day care centers
  and 28 medical vans
• These are managed by NGO/network of PHC and
  subentries in the rural areas.

15
Geriatrics in India

• Most hospitals do not have a special geriatric
  facility. At present most elderly patients are
  still being treated in general medical wards.
• There is only one hospital in Chennai that gives
  post-graduate (M.D.) education in geriatric
  medicine!
• Similarly the nursing and other para-medical
  staff are not formally trained in providing care
  for elderly patients.

16
Distribution of Chronic Diseases in Aged (n1000)
India   Rural   Rural   Urban   Urban  
Chronic Disease Chronic Disease M F M F
Cough   250 1958 179 142
Piles   33 16 32 18
Joint Problems Joint Problems 363 404 285 393
High/low BP High/low BP 108 105 200 251
Heart Disease Heart Disease 34 27 68 53
Urinary Problem Urinary Problem 38 23 49 24
Diabetes   36 28 85 66
Cancer   2 3 2 4
Any of the above Any of the above 527 514 528 560
National Sample Survey 52nd Round Survey, 1995-96
17
Distribution of Physical Disability in
Aged (n1000)
India   Rural   Rural   Urban   Urban  
           
Disability   M F M F
Visual   249 291 225 260
Hearing   139 156 111 132
Speech   32 38 29 3
Locomotor Locomotor 107 115 80 94
Amnesia/Senility Amnesia/Senility 96 113 61 80
Any Disability Any Disability 380 425 333 367

National Sample Survey 52nd Round Survey, 1995-96
18
The policy Initiative in India

• 1999 Indian Government announced a National
  Policy on Older Persons
• policy implementation is to be monitored by 
  National council for Older Persons (NCOP).
• joint responsibility of the state and Central
  governments
• in December 2007 Indian parliament has passed a
  bill known as Maintenance of parents and Senior
  citizens Act

19
Policy aims to.

• to encourage geriatric units in hospitals and
  clinics
• infirmary care units
• emphasis on family care of the aged through
  incentives and schemes for the needy families
• promotion of values through formal education and
  media
• subsidizing old age homes and day care centers
  

20
Geriatric Nursing Care Workshop (November 07)

• In collaboration with NICE/ICCE
• 5 day workshop
• Attended by nursing staff of different hospitals
  in the state of Rajasthan, India.

21
Aims of the Workshop

• Provide improved ideas and practices in the Care
  of elderly
• Refine existing practitioners skill in the care
  of elderly
• Draw attention of general practitioners to the
  needs of care of elderly
• Positively influence Government policy
  initiatives on geriatric care

22
Indian Gerontological Associationwww.gerontologyi
ndia.com

• Established in 1968
• Devoted to well being of Senior citizens
  research on ageing
• Indian Journal of Gerontology -1969
• Affiliated to IAGG in 1971

23
Indian Gerontological Association

• Runs a Day Care Centre
• Runs a counselling centre for elderly
• Organises training for family care givers
• Organises lectures on diseases common in old age
• Consultancy for NGOs working for elderly

24
In Summary

• Elderly population in India is increasing.
• Status of elderly changing in family.
• Geriatrics is in incipient stage.
• NGOs have important role to play in creating
  awareness, imparting information and training of
  support services.
• We need to learn from the model of geriatric care
  in the developed countries.

25
THANKS
By Dr. K.L. SHARMA