ELDERLY

ELDERLY CARE
CARE IN
IN
INDIA-CHANGING
INDIA-CHANGING
PERSPECTIVES
PERSPECTIVES
 TRADITION SPEAK…

One who always serves and respects elderly

is blessed with four things : Long Life,
Wisdom, Fame and Power”
Manusmriti Chapter 2:121
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

 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

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.
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.
 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.
 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.
 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).
 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.
 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…
Distribution of Aged Persons by
State of Economic Dependence
(n=1000)
Not Partially Fully No
 
  Dependant Dependant Dependant 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

Distribution of  Care Provider of
Economically Dependent Aged

Spouse Own Grand Others

 
    Children Children  

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

 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.
 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.
 Distribution of Chronic
Diseases in Aged (n=1000)
Rural Urban
India      
Chronic Disease M F 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 2 4
Any of the above 527 514 528 560

National Sample Survey 52nd Round Survey, 1995-96

 Distribution of Physical
Disability in Aged (n=1000)

Rural Urban
India      
           
Disability   M F 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 80
Any Disability 380 425 333 367

National Sample Survey 52nd Round Survey, 1995-96

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
 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
 Geriatric Nursing Care
Workshop (November ’07)

• In collaboration with WHO

• 5 day workshop
• Attended by nursing staff of
different hospitals in the state of
Rajasthan, India.
 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
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
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
 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.
THANKS