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 2:121

3. Worldwide Trend of Population of 60 Years and Above : 1980-2020
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
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
5.6
Latin America
6.5
8.8 11
Asia (excl. Japan)
7.4
8.5
9.8
12.8
China 9
10.5
12.4
16.6
India
7.3
8.4
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 doctor’s 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 (n=1000)
Not
Dependant
Partially
Fully No
Response
Rural
Male
485
180
313 22
Female
121
146
706 27
Urban
515
169
297 19
115
110
757 18
National Sample Survey 52nd Round Survey,

13. Distribution of Care Provider of Economically Dependent Aged
Spouse
Own
Children
Grand
Others
Rural
Male
113
766 50 71
Female
159
717 52 72
Urban
105
792 54 49
182
695 56 67
National Sample Survey 52nd Round Survey,

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 (n=1000)
India
Rural
Urban
Chronic Disease M F
Cough
250
1958
179
142
Piles 33 16 32 18
Joint Problems
363
404
285
393
High/low BP
108
105
200
251
Heart Disease 34 27 68 53
Urinary Problem 38 23 49 24
Diabetes 36 28 85 66
Cancer 2 3 4
Any of the above
527
514
528
560
National Sample Survey 52nd Round Survey,

17. Distribution of Physical Disability in Aged (n=1000)
India
Rural
Urban
Disability M F
Visual
249
291
225
260
Hearing
139
156
111
132
Speech 32 38 29 3
Locomotor
107
115 80 94
Amnesia/Senility 96
113 61
Any Disability
380
425
333
367
National Sample Survey 52nd Round Survey,

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 practitioner’s 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 Association www.gerontologyindia.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
Thanks to
DR. K.L.SHARMA
INDIAN GERONTOLOGICAL