Coping with ailments may not be an easy task for the elderly. Right medical care and counselling is needed to tackle the condition and depression that many encounter, say doctors.
“In a community of 100 elderly persons, at least 30 might have diabetes, around 40 might be hypertensive,” says B. Krishna Swamy, Head of the Department of Geriatrics, Rajiv Gandhi Government Medical College and Hospital. “About 30 per cent of those over 60 years of age become hypertensive but the percentage increases to 60 in the 80-plus age group,” he says, adding that at least 30 per cent of the elderly who are over 90 years have dementia.
Senior geriatrician V. S. Natarajan opines that about 15 per cent of the elderly who come to private clinics may suffer from depression. Physician T.M. Perumal, who provides emergency house-care for elderly persons says, “Those in the 80-plus age group tend to suffer from depression when their sons or daughters retire from service.” However, depression could set in irrespective of financial well-being or availability of support. Family problems, bereavement or chronic ailments might bring about depression. Escalating healthcare cost might be a source of constant worry, he admits.
President of Tamil Nadu Public Health Retired Officials' Association D. Dasaratharaman calls for free master health check-up in government hospitals for those aged over 70. He contends that as “pensioners have already contributed Rs.100 a month to the government from their family pension towards Health Fund Scheme, those above the age of 70 with several health ailments should be given free health services.”
Geriatricians, however, focus on older persons. “As geriatricians, our focus is more on the frail elderly, those over the age of 80,” says Dr. Krishna Swamy as this segment becomes increasingly dependent, immobile and disabled. This geriatric population requires focused healthcare as they are prone to suffering from physical and mental disability, he says.
Dr. Natarajan, along with Senior Citizens' Bureau, has launched a comprehensive doctor-on-call programme, providing specialised care for the elderly. “It requires a team that includes specialists, nurses, physiotherapists, psychologists and counsellors,” explains Dr. Natarajan. Geriatricians are also fighting to ensure that the elderly can access healthcare closer home.
Since the 1990s, that the State and the Central government are paying more attention to the health needs of the geriatric population. The Madras Medical College was the first to introduce an MD course in geriatrics in the country in 1996. From a 30-bed geriatric ward, the Government General Hospital now has 60 beds. But, only two other medical colleges in the State have trained geriatricians.
The National Policy for Older Persons, 1999 and the National Programme for Health Care of the Elders, envisaged by the Eleventh Plan have started gaining momentum. Under this programme, it is proposed to train doctors at district, taluk and primary health centres in geriatric care.