Lack of geriatric specialists proves a major roadblock for the elderly.
With one out of every five Indians over the age of 60 by 2050, the inadequate supply and demand between the number of doctors specialising in geriatrics and those in urgent need of care poses a serious challenge.
This year the World Health Organization flagged ‘Ageing and Health' as its theme for World Health Day (April 7), an issue that impacts India as much as other nations, with the country struggling to provide proper care to its greying population. While there are several issues regarding the aged that need attention, particularly acute is the sheer lack of geriatrics even as the 2011 census shows a significant increase in the their numbers.
“While increasing number of elderly people in any society is a success story of socio-economic development and good public health practice, it also denotes an economic crisis, a social crisis due to increased demand and inequitable supply,” says Dr A.B. Dey, Professor, Department of Medicine and Head, Department of Geriatric Medicine at the All India Institute of Medical Sciences.
Dr Dey, who was one of the keynote speakers at a half-day media consultation by HelpAge India, felt that unlike western countries — where the patient-to-geriatrics ratio is more balanced — institutional care is not at all prevalent in India. And that is what compounds the problem. The magnitude of the problem can be judged from the fact that even in a place like AIIMS all the posts of senior geriatrics except one are vacant.
It is not as if the situation is any better in the private sector. “Geriatric medicine,” says Dr Dey, “goes against the working philosophy of the private healthcare sector… More procedures and quicker discharge do not favour older patients.”
Even among medical students, very few take up geriatrics as an area of specialization. Old age and Geriatrics is not glamorous for young professionals not only in India but in most developing countries. There are no “hi-tech scopies and plasties” in geriatric medicine. It has more to do with concern and care.
Health problems in old age can range from increased susceptibility to infection, inability to cope with physical and psychological stress, degenerative arthritis, atherosclerotic and vascular diseases of heart and brain, cancer of various organs and cognitive impairment due to declining brain size or more importantly various types of dementias.
Even at the policy level, the situation is not very encouraging. Geriatrics or old age care is not a priority for the government as most planners see it as wasteful expenditure with no future returns. According to Dr Ray, the recent trend is to club old age care with the non-communicable disease programme.
In addition, to ensure the availability of more specialized doctors for senior citizens, there is a need to increase the number of beds for older patients in all hospitals and to reduce the cost of care. This, HelpAge believes, can only be done by providing either free or subsidised medicines, proper insurance as healthcare for the aged demands enhanced funding.
It also believes that long term care policies need nuanced deliberations to create an environment that provides the elderly equal opportunities, protects their rights and enables their full participation in society.