Everything comes full circle, they say. It is the same for the joint family system, according to geriatrician V.S. Natarajan.
In the last 40 years since he set up geriatrics specialty in the Madras Medical College, he has seen many changes — from people dying of infectious diseases to the elderly becoming dependent on their families because of the disability caused by non-communicable diseases.
Dr. Natarajan says, “When I started the geriatric ward in GH in the 1980s, people suffered from chest infection, scabies and leprosy that were easy to treat. Now, we see people with diabetes, stroke and dementia. At that time, physicians used to go to the patients’ house.” With no family planning and a robust joint family system, the elderly received care from other family members. Medical advancement in the last 40 years has meant the death rate, which was over 25% in 1950, will be reduced to 7.5% in 2023.
Longevity may have increased but the elders have to face three Ds — disease, disability and dependence. A diabetic becomes dependent owing to retinopathy; mild Parkinson’s disease progresses, leading to dependence five years later.
The next decade spells a better future for geriatricians as the lifespan of the population increases. The government must gear up to provide services to the elders. “We started the Institute of Geriatrics with two postgraduate students. Now, we have nine PGs. The government can use these specialists in district headquarters hospitals and for house call programmes for the elderly. This would help to treat chronic diseases,” he says. The house call programme he launched in 2008 has treated over 10,000 elderly and saved many lives.
Dr. Natarajan has been organising awareness programmes in schools on elder abuse. More homes for the aged in rural areas and offering free vaccination to the elders at primary health centres are the way forward because in the next 25 years every fifth person would be elderly.
He wants the old age pension expanded to cover daily wagers. The pension amount must be increased to ₹3,000, he says.
The demographic change could also bring about some changes, such as elderly marriages. More elderly women and widows would be working. Men are prone to vascular diseases such as heart attack and stroke, besides accidents, unlike women, who are protected by their hormones.
Another welcome change could be the return of the joint family due to work compulsions. “When that happens, disease may not be a burden,” he says.
Thursday was observed as the International Day of Older Persons.
