Looking up to the elderly

Elders have the best of healthcare, but social security a concern

M. Dinesh Varma

CHENNAI: : For senior citizens, it is the best of times with rapid advances ushering in effective treatment for every conceivable age-related ailment — from heart surgery to knee replacement. But, in terms of social security, it is perhaps the worst of times with the twilight phase marred by extreme loneliness, psychological and even physical abuse.

The occasion of this year's United Nation's International Day for Older Persons on Saturday prompts a closer look at the gaps between the special needs of the elderly and lack of social security measures.

The increase in life expectancy has been substantial in the last 58 years — from 47 years in 1947 to the current average of 62 . By 2050, the projectedfigure is 70 years.

Demographic reshuffle

In a demographic reshuffle projected by HelpAge India, the proportions of people above 60 years is estimated to rise from the seven per cent now (roughly seven crores) to 8 per cent by 2011 and 17 per cent by 2025, says V. S. Natarajan, Chairman of the Senior Citizens Bureau, an organisation working for the elderly, and former Madras Medical College geriatrician.

In other words if one in 12 persons is an elderly in 2005, one in five would be an old person by 2050.

By then, geriatric super-specialities in cardiology, neurology and psychiatry streams could be common, said Dr. Natarajan.

Accounting for the benefits of advances in stem cell treatment, gene and hormone therapy, the number of survivors in their 90s and 100s is likely to shoot up.

When Dr. Natarajan set up the first geriatric ward in the country at the General Hospital in 1978, awareness about the speciality was lacking in both patients and practitioners.

In fact, ageing persons were into denial and refused to accept that they were old. Treatment in those days was not as advanced as they are now and deaths due to heart attacks, liver or kidney failure were virtually inevitable. Mortality rates were high in the 60-65 age group.

Increased life expectancy

With increased life expectancy, Dr. Natarajan's geriatric clinic attendees are now sharply divided into two categories: Patients on follow-up rolls who are beneficiaries of modern medical advances and have undergone bypass surgery or hip replacement and old people with disabilities such as failing vision or hearing, severe arthritis or dementia.

Many patients had to depend on maidservants or friends to reach the clinic.

Among nuclear families, seeking out an old age home for the elderly is increasingly becoming the first rather than the last resort.

Even elderly people who live with their children face several problems such as abuse, Dr. Natarajan said.

"We aim to help the elderly live with dignity and die with dignity," said Indrani Rajadurai, Director, HelpAge (Southern Region) which has planned elaborate week-long celebrations from October 1.

The organisation's interventions range from counselling services, `Adopt-a-Gran' schemes, mobile medicare unit and a Helpline (1253).

Dr. Natarajan points out that the Union Government is yet to come out with the promised National Policy on Ageing.

An estimated 58 per cent of elderly women in the country who are widows represent a significant segment requiring special services, he said.

The silver linings include Union Health Minister, Dr. Anbumani Ramadoss's commitment to bring the proposed Rs. 100-crore

National Institute of Ageing to Chennai, opening of more geriatric wards in State and private hospitals, geriatric societies to deliver special needs of the elderly and growing popularity of the commune-styled community living.

Awareness walk

To commemorate the world elders' day on October 1, the Alzheimer Related Disorder Society of India along with Novartis India is conducting an awareness walk from the Light House in Marina on Saturday morning. Eminent personalities, including retired judges, leading doctors in the city will participate in the walk.

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