money, some family members may harness their own greed and use it to cuddle up to

the
elderly in hopes of receiving a lump of income when they pass on.
Over 11,500 people per day pass the 65 year milestone in the United States alone
Each year, approximately lou,000 people go past the century mark.
The vast majority of surplus cash sits in the hands of today's elderly. Marketers
know
this. More and more products and advertisements are targeting people beyond their
retirement
years. Pain medications, denture adhesives, Medicare supplemental insurance, and a
host of
other products specihically target this market.
It seems that everyone but those who should love them tend to be aware of the value
of the elderly today. Nursing homes are multiplying. Doctors have learmed how to
milk the
cow of Medicare and medigap policies with multiplied testing and monthly or
quarterly
office visits.
Walkers, canes, and wheelchairs have become more user friendly with wheels on
walkers and multiple legs on canes and motors on wheelchairs. Everywhere we look,
our
society is working to catch the dollars of the aging population.
Elderly Care and Needs
Needs of the elderly can be of various types such as financial needs, health
needs, nursng requirements, etc. We will have a look at all of them one by one.
1. Financial Needs of the Elderl
If elderly ndividuals happen to be living on their own, L.e. without anyone else's
support, it is but natural that they will have a certain amount of financial needs.
They
wl neca to rend Tor nemselves or everyiing sucn as TO0u, groceries, medlcnes,
etc. Pensioners would have the benefit of a steady source of monthly income
(whatever be the amount trickling in). However, those senior cilizens who do not
have
any pension facilities or any other sources of income, would have to live entirely
on
the basis of their savings or through special senior citizen government finance
schemes.
2. Health Care Requirements
Senior health is the most important requirement when it comes to needs of the
elderly.
With advancing age, the body tends to slow down and becomes less efficient. Elderly
consider installing certain medical alarms that are specially made keeping in mind
elderly citiZens.
Health Insurance for Senior Citizens in India
Any individual aged 60 years or above is called as senior citizen. These citizens
have worked
hard all their lives and contributed to the development of the nation and the
community.
Though generally ignored and sometimes shunned by the younger community but there
is
much to learn trom them. Some continue to be productive and work in various
capacities
Most organisations and universities entertain these skilled manpower up to the age
of 65 to
0 years.
The senior citizens need to be cared for and the society and nation owes them a
decent life in
their old age. Keeping these sentiments, the Indian Government of India, has
introduced
several benefits through its varioUs schemes in tor senior citizens. One amongst
such schemes
includes health insurance policy.
The schemes and policies are meant to promote the health, well-being and
independence of
senior citizens across the country. With numerous tax benefits, travel and
healtheare facilities
exclusively designed and provisioned for them, Indian Government has created
sutficient
reasons for Senior Citizens to feel satistied and elated. The central govenment of
India came
out with the National Policy for Older Persons (or Elderly Individuals) in 1999.
These
guidelines aim to encourage individuals to facilitate provisions for selt as well
as their
spouse's old age. It also strives to encourage families to take special care of
their elderly
family members who are often dependant on the bread-winners in the family. Ihis
policy has
been designed to enable and support voluntary and non-governmental organizations
(NGO s)
to supplement the care rendered by the family and provide care and protection to
these
Vulnerable lot. Healthcare, creation of awareness, training facilities to geriatric
caregivers/service providers and healtheare research have also been looked into and
implemented under this policy. The main purpose of this policy is to make elderly
people
fully independent citizens.
National Policy for COlder Persons has resulted in the launch of new schemes listed
below
Strengthening of primary healthcare system in order to fulfill the requirements
pertaining to
National Mental Health Program focuses on the needs of elderly individuals who are
affected with Alzheimer's Disease Dementia, Parkinson's disease, Depression,
Psycho-
somatic disorder and P'sycho-Gieriatric ailments.
The jourmey towards financial security does not end here. The Central Goverment of
India is
constantly in the process of evolving and rolling-out of newer plans and schemes to
benefit
senior citizens across the country. In the 2007-08 Budget, the Finance Minister had
proposed
to provide monthly income to seniors and develop new healthcare insurance schemes.
For the benefits of senior citizens various schemes have been introduced that
includes:
The National Housing Bank - has introduced a reverse mortgage scheme under whicha
senior citizen owning a house in India can avail of a steady monthly stream of
income against
mortgage of the house. 1The senior citizen remains the legal owner and occupies the
house
throughout his or her lifetime, without repayment of the loan. Regulations are to
be initiated
for creation of mortgage guarantee companies.
Exclusive health insurance schenmes for senior citizens offered by select Insurance
Companies
The Maintenance of Parents and Senior Citizens Bill of 2007 - This bill facilitates
care
for the maintenance of aged parents, establishment of old homes, provision of
medical care
and protection of life and property of senior citizens.
These new developments concerning senior citizens are meant to get such individuals
on the
path to a better, peaceful, stable, financially sound and secured lite.
rhe role of the nurse
Older people's continuing care needs are met in a variety of settings, including
their own
home, supported housing. residential care, a nursing home or hospital. At some
stage many
older people are likely to require registered nursing care.
people are prone to a few age-related health issues. This is a normal aspect of
life and
one cannot help it. However, through proper care and nursing facilities, one can
definitely help in keeping most of these health issues in check and preventing them
from causing any serious harm. Regular medical checkups IS necessary. They can help
in anticipating potential future health-related isues. At the same time, they may
help
in identitying serious health problems at an early enough stage during which
treatment is possible
3. Dietary Requirements
As people age, their digestive system gradually starts weakening. Aged and elderly
people especially, face this problem wherein they start finding certain foods
ndigestible or diicult to digest. what one must reallzZe is that their diet can no
longer
be the same as it was say, twenty years ago. Their diet should now be modified
accordingly such that it remains a nutritious, balanced diet and yet, contains
foodstufis that their system is able to accept, without causing them any discomtort
or
problems. Often, the diets of elderly people need to be altered depending on their
medicinal prescriptions.
4. Nursing Requirements
lf you have an elderly family member whose mobility has become limited due
to aging, he or she would require a certain amount of assistance in his or her
daily
routine. i it is not poSsible tor someone in the tamily to be around the aged
person the
whole day long. you could consider having a full-time nurse to assist the elderly
person. This could be beneficial, especially if the elderly person requires
assistance in
basic activities like walking, eating, bathing, dressing, etc.
5. Social and other Needs of the Elderly
One thing that you should keep n mind is, to shower all your love and care on your
eldery relative or tamily member. Just because they have become old and slow, does
not mean that you should ignore them or let them be contined to themselves.
Remember, a few years down the line, you yourself will be in their position. Spend
time with them, chat with them and make them feel wanted, cared for and loved. Pay
special attention to their room. You could consider installing a few senior citizen
friendly appliances which they would be comfortable using Also, you should
Geriatrie Considerations in Nursing
Introduction
Gieriatric nursing is a nursing subfield which involves caring for older adults.
Older
adults have special needs which cian become very Complex, making employment
prospects n
the field of geriatric nursing very good. As people live longer with the assistance
of modern
medical developments, many older people require extended specal care trom members
of the
health profession who specialize in geriatriC health issues. To become a geratric
nurse,
someone must generally qualify as a nurse and take additional courses in geriatric
nursing to
ICarm lo mect the specitic necds ot otder patienis,
You may also hear this nursing field referred to as " gerontological nursing."
depending on regional preterences. Numerous professional organizations
for geriatric nursing can be found around the world, offering additional training,
certification,
and support for people who work in this field. Geriatric nurses can also take
advantage of
trade journals, research programs, conferences, and other things which are designed
to
promote knowledge and cooperation in the field.
Caring for the elderly can be very complex. In addition to providing basic nursing
services, a
geriatrie nurse must also offer emotional support to patients, watching out for
their mental
health and keeping a close eye out for medical conditions which can emerge quickly
in the
elderly. Geriatric nurses must also be able to coordinate with the families of
their patients,
and sometimes they work side by side with family caregivers, offering training to
help them
care tor their tamily members while taking care oft complex nursing tasks.
Geriatrics
Geriatrics IS a sub-specialty of internal medicine and family medicine that focuses
on health
care of elderly people.
Aims
It aims to promote health by preventing and treating diseases and disabilities in
older
Geriatries, the care of aged people, differs trom gerontology, which is the study
of
the aging process itselt. The termm gertatrics comes from the Greek geron meaning
"old man
and iatros meaning "healer". However, geriatrics is sometimes called medical
gerontology.
The geriatric population is defined as population aged 60 years and above
According to the 1991 census, the geriatric population constituted 6.3% of the
total Indian
population As a proportion of the total population, the geriatric population has
been steadily
increasing over the decades. This rapid growth of the population of the elderly is
a challenge
to the medical profession, the administration and society. The elderly people
sutfer from a
variety of problems which are increasingly drawing the attention of the Govermment
and the
public.
On retirement, the inc ome is suddenly reduced. Economic hardship. with continued
low
standard of living, affects the body and the mind. Retirement, change in housing.
ilness or
death of spouse greatly affect the physical wellbeing of the aged person. The
socioeconomic
problems of the elderly are aggravated by the lack of social security, inadequate
facilities for
health care, rehabilitation and recreation. In most of the developıng countries.
pension and
soCial securnty IS restricted to those who have worked in the public sector or the
organized
sector of industry
Ihe mental changes include impaiment of memory. ngidity of outlook and disike of
changing trends (especially sociocultural norms). The social problems have been
caused by
the break-up of the joint family system. the nuclearization of families, housing
shortages in
urban areas and the increasing participation of women in the workforce. Women
continue to
be the health care providers for the elderly at the household level.
Human ageing 1s characterized by progressive decline (referred to as
homoeostenosis) in the
homoeostatic reserve ot every organ system. 1his phenomenon is usually evident by
the third
decade although, the rate and extent of the decline may vary. The decline of each
organ
system appears to occur independently of the changes in the other organ systems and
is
ntluenced by diet, environment, personal habits and genetic factors. The dder ly
sufter from
health problems due to the ageing process like-senile cataract. glaucoma, nerve
deafness,
musculo-skeletal changes affecting locomotion, failure of special senses and poor
retlexes
(resulting in accident proneness) and enlargement of prostate in males.
Elderly people in modern society
Becoming elderly used to be considered a sign of reverence and distinction. People
would seek out the elderily tor their wIsdom and expenence. Ioo many times in
todays
society growing old means being considered a family nuisance. Like a pet that has
outlived
its usefulness, the elderly are moved to places to be out of sight and out of mind.
If they have
Older people in hospital or who hve in care homes are ikely to be vulnerable.
Indeed the
RCN would argue that if older people are vunerable enough to require placement in a
care
home, then it is likely that some level of nursing intervention will be needed.
1The role of the
nurse as an enabler of health in older people is crucial in continuing care
settings (RCN,
2004a).
ln a care home, registered nurses have multiple roles that retlect the diverse
nature ot nursing.
Different functions that contribute to the optimum health and overall wellbeing of
older
people include:
Supportive- including psychosocial and emotional support, assisting with easing
transition,
enhancing ifestyles and relationships, enabling life review, facilitating self-
expression and
ensuring cultural sensitivity.
Restorative - aimed at maximising independence and functional ability, preventing
fur there
deterioration and'or disability, and enhancing quality of life. This is undertaken
through a
focus on rehabilitation that maximises the older person's potential for
independence,
including assessment skills and undertaking essential care elements, for example,
washing
ind dressing
Educative - the registered nurse teaches self-care activities - for example, self-
medication -
health promotion, continence promotion and health sereening. With other statt, the
registered
nurse engages in a variety of teaching activities that are aimed at maximising
confidence in
competence and continuously improving the quality of care and service delivery
Lite-enhancing - activities that are aimed at enhancing the daily living experience
of older
people, including relieving pain and ensuring adequate nutrition
Managerial - the registered nurse undertakes a range of administrative and
supervisory
responsibilities that call for the exercise of managerial skills. Such
responsibilities include the
supervision of care delivered by other staff and the overall management of the home
nvi ironment
healthcare needs of elderly.
Provision tor separate queues and reservation of beds for elderly patients in
hospitals and
nursing homes.
mparting necessary training and orientation programs designed tor medical and
paramedical personnel in Cieriatric eare. Assistance to societies for production
and
distribution of materials related to geriatric care.
Promotion of the concept of healthy ageing process, preventive healthcare aspects
and
well-being oft Senior Citizens.
Extended coverage under the Antyodaya Scheme witlh special emphasis on provision ot
Tood at subsidized rates tor the Senior Citizens especally the destit ute and
marginalized
sections of Indian Society.
"The Integrated Programme for Older Persons'" 1s a scheme that provides financial
assistance
up to 90 per cent ot the project costs to non-governmental organizations or NGOs
nvolved in
their care. This money is used to establish and maintain old age homes, day-care
centres, and
mobile medicare units as well as to provide non-institutional services to elderly
individuals.
The scheme also incorporates other requirements of elderly citizens such as
reinforcing and
strengthening the family bonds, generation of awareness on family related issues
and
facilitating productive ageing.
Another important program introduced by the Government of lndia is the Scheme of
Assistance to Panchayati Raj Institutions, voluntary organizations and Self-Help
Groups for the construction of Old-Age Homes and Multi-Service Centres for Senior
Czens. 1 nis seneme provides a one-tme constructon grant
Central Government Health Seheme (CGHS) provides pensioners or retired employees of
central government various healthcare lacilities for availing treatment and
obtaining
medicines for chronic (or long-standing) ailments up to three months at a stretch.
T he