i201611301.jpg

Author : Santosh Jain Passi, Akanksha Jain

The ageing of populations is rapidly accelerating with increasing life expectancy worldwide. Ageing involves changes in physiological, pathological, social,100110234-101d41705a242d6edd2fae990729f484654c2ef2.600x400.jpg and psychological conditions of the individuals; however, the resultant capacities and health needs of the elderly are not random. These are rooted throughout the life-course and can often be modified, highlighting the importance of a life-cycle approach. The aim of health care has changed enormously; joint family system has largely been replaced by independent living. This shift in family system can mainly be attributed to greater life expectancy, independence and self-esteem of the elderly on one hand, and on the other hand is the freedom of living/non-interference cherished by the younger generations. However, increasing life span is often accompanied by diseases, disorders and disabilities with their consequent loss of independence.

Lifespan_logo_final_2x.png

During the last few decades, major chunk of the disease burden has shifted to non-communicable diseases and resultant disabilities rather than pre-mature deaths caused by infectious diseases. Increasing life span and poor health care compound the degree of disability among the elderly and pose problems for the care givers. Meeting the specialised health care needs of the elderly with multi-morbidity is a great challenge being faced by the health-care systems across the globe. For the first time in history, majority of the individuals can expect to live beyond 60 years. Ageing population has, therefore, been a matter of great concern for the policy makers all over.

agedcouple.jpg

In the year 1901, India’s elderly population was just 12 million which rose to 19 million (1951), 77 million (2001), 104 million (2011) and it is anticipated to touch 137 million mark by 2021. Our country which houses the 2nd largest number of aged people in the world, has taken merely 25 years to double its elderly population.

Population (in millions) Male Female Total
India’s Total Population 623.3 587.6 1210.9
Population aged 60+ 51.1 52.8 103.9
              Rural 36.0 37.3 73.3
              Urban 15.1 15.5 30.6
Elderly as % of Total Population 8.2 9.0 8.6

*(Source: Population Census 2011, SRS Report 2013)

Largely, the problems of elderly arise from inadequate income, lack of suitable employment opportunities, poor housing conditions, physical and psychosocial health issues, absence of social safety-nets, stresses and strains associated with changing family patterns and lack of appropriate post-retirement activities. Changes in socio-economic status adversely affect the elderly’s way of life. Therefore, appropriate ways and means of stress management need to be explored and implemented.

Age related physiological decline comprises changes in the normal body functions leading to poor mobility, failing vision, impaired hearing, eating/digestion problems, loss of memory coupled with inability to control certain physiological functions (particularly urinary- incontinence) and various chronic diseases/disorders. Rapid urbanisation and unhealthy lifestyle are the root cause of escalating incidence of age related chronic disease such as heart disease, cancer, diabetes etc. Economic dependency on children/relatives, loss of authority and lack of social recognition result in poor self-esteem of the elderly; and this situation is expected to worsen in the coming years.

Aged-Care.jpg

For the elderly, appropriate nutrition is imperative for good health as it can affect the entire ageing process. Compared to the youngsters, elderly are more vulnerable since ageing is accompanied by diminished functional status including impaired muscle function, loss of bone mass, immune dysfunction, anaemia, reduced cognition, poor wound healing recovery and frequent morbidity/hospitalisation/surgery which can often result in mortality. With the changing scenario, elderly are usually left to fend for themselves which invariably affects their health and nutritional status. Due to reduced food intake and lack of dietary diversity, they commonly suffer from micronutrient deficiencies.

Despite multiple health problems, old-age should not imply dependence. Appropriate interventions including health promotion, disease prevention and primary to palliative care need to target the elderly so as to add healthy years to their lives!

active_aging

In 2002, WHO released a policy framework – Active Ageing which emphasizes the need for multi-sectoral actions to ensure that “older persons remain a resource to their families, communities and economies”.

big-determinants_active_age1

The  increasing  proportion  of  elderly subject the welfare schemes and  health-care  systems  as  well  as  their families  under  pressure. The fact that more and more people will live longer, it will add to the existing burden of chronic diseases and disabilities – putting additional strain on the society. Therefore, the welfare policies/schemes and the health care systems need to be designed appropriately.

In India, Ministry of Social Justice  and  Empowerment in  close  collaboration  with  StateMinistry-of-social-justice-and-empowerment-Recruitment-2016.png  Governments,  Non-Governmental  Organisations  and  civil  societies develops  and  implements  various programmes for  the senior  citizens.  Under the Scheme Integrated Programme  for  Older  Persons (IPOP), the Ministry runs several projects Maintenance of Old Age Homes and Respite Care Homes which include running of Multi Service Centres for Older Persons; Maintenance of Mobile Medicare Units; running of Day Care Centres for Old Persons with Alzheimer’s/Dementia; multi facility care centre for older widows; physiotherapy clinics; Regional Resource and Training Centres and several other programmes to benefit the elderly.

“Ageing well” must be a global priority!!

active_ageing_7.jpg

The concept of Active and Healthy Ageing needs to be promoted, which includes preventive, promotive, curative and rehabilitative aspects of the elderly’s health!!

To quote Dr Chatterji (WHO)“Collectively, we need to look beyond the costs commonly associated with ageing to think about the benefits that an older, healthier, happier, and more productive older population can bring to society as a whole.”

Our elders are the treasure house of unbeatable experience…we should respect them and care for them!! As there is a saying, “The best classroom in the world is at the feet of an elderly person”.

*Dr Santosh Jain Passi – Public Health Nutrition Consultant; Former Director, Institute of Home Economics, University of Delhi

* Ms Akanksha Jain – Ph D Scholar, – works in the field of Public Health and Nutrition.

Advertisements