Geriatric health old age in new india

Presented by: Dr. Madhu Gaikwad, Post Graduate student, Pt. J.N.M. Medical College, Raipur.

1. Geriatric Health - Old age in New India. 1 Presented by- Dr. Madhu Gaikwad (2 nd year Post Graduate Scholar) Guided by- Dr. Shubhra A. Gupta Dr. Smita Verma Department of Community Medicine Pt. J.N.M. Medical College, Raipur (C.G.)

2. “You do not heal old age. You protect it; you promote it; you extend it” - Sir James Sterling Ross. 2

3. Lesson Plan What is Geriatrics? Global and National burden of geriatric population. Health Problems of geriatrics Level of preventions Programs and policies related to it. 3

4. Contents Introduction Health problems of elderly Preventive measures Health programs and policies related to elderly 4

5. Terminologies Gerontology Geriatrics Preventive Geriatrics Ageing Senescence Active Ageing 5

6. Gerontology : “The study of physical and psychological changes which are incident to old age is called gerontology”. Geriatrics : Branch of medicine that deals with the health of the elderly. Also known as Clinical Gerontology. Preventive geriatrics : focuses on prevention and reduction of disability and improving the quality of life of elderly. Park Textbook of Community Medicine, 24 th Edition 6

7. Aging : Aging is a predictable, progressive and universal deterioration in various aspects of health related to mental, physical, behavioral and biomedical domains. Senescence : Deterioration in the vitality or lowering of the biological efficiency or feebleness of the body and mind, associated with the process of aging. Park Textbook of Community Medicine, 24 th Edition 7

8. Active aging : Process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. Active refers to continuing participation in social, economic, cultural, spiritual and civil affairs. Park Textbook of Community Medicine, 24 th Edition 8

9. Introduction United Nations defines the cut off point for elderly at 60 years. According to WHO, for most of the developed countries it is 65 years. In India- 60 years and above * Young Old - up to age of 75 years Old old - 76 to 85 years Very Old - after 85 years. * Ministry of Social Justice and Empowerment, Jan 2016 9

10. Demographic Transition Handbook on Social Welfare Statistics, Ministry of Social Justice and Empowerment, GOI, Jan 2016 10 India is in Late Expanding phase.

11. Handbook on Social Welfare Statistics, Ministry of Social Justice and Empowerment, GOI, Jan 2016 11 Advances in medicine Increase in the geriatric population Increased the life expectancy Decreased fertility rates

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13. Populations are getting older Aboderin IA, Beard JR. Older people’s health in sub-Saharan Africa. Lancet. 2015 Feb 14;385(9968):e9–11. doi : http://dx.doi. org/10.1016/S0140-6736(14)61602-0 PMID: 25468150 13 2015 2050

14. Globally elderly constitute 11 % of total population. 901 million 2.1 billion In India : Elderly constitutes the 8.58% of total Indian population. United Nations Department of Economic and Social Affairs ǀ World Population aging, 2015 14

15. Life expectancy 66.1 YEARS Handbook on Social Welfare Statistics, Ministry of Social Justice and Empowerment, GOI, Jan 2016 15 68.9 YEARS

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17. United Nations Department of Economic and Social Affairs ǀ World Population aging, 2015 17

18. Theories of aging process Textbook of Community Medicine, Piyush Gupta 18 Somatic Mutation Theory Autoimmune Theory Hayflick’s Theory

19. Health problems in Geriatrics 19

20. 20 Physical Problems

21. Source : Report on Independent Commission on Health in India 21

22. Psychological problems Emotional disturbance Feel lonely, neglected & unwanted Anxiety, Depression & Suicidal tendencies Impaired memory Decline in sexual performance Rigid outlook Park Textbook of Community Medicine, 24 th Edition 22

23. Loneliness and social isolation Rapid disintegration of joint family Changes in social contact due to retirement Bereavement- Death of spouse / siblings, close relatives, separation of their children after marriage http://www.annalsofcommunityhealth.in/ojs/index.php/AoCH/pages/view/prege 23 Social Problems

24. Social Problems Diminished participation in social and cultural activities Change in the attitude of community towards elderly Inability to adopt with changing environment. http://www.annalsofcommunityhealth.in/ojs/index.php/AoCH/pages/view/prege 24

25. Economical Problems More common in females than in males . Retirement Self employed like farmers, daily wages earners can’t earn their livelihood due to disease and disabilities. 25

26. Preventive Health care in elderly Health Habits 26

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28. Secondary Prevention Annual Health checkups Screening for Hypertension & Stroke Diabetes Osteoporosis Periodontal Disease Sensory impairment Medication side effects Cancers- colorectal, prostate, breast, cervical Nutritionally induced anemia Depression, stress 28

29. Tertiary care 29

30. Senior Citizens in India: Constitutional Benefits and facilities 30 Article 41 of Indian Constitution deals with the State’s role in providing social security to the aged. According to this article, “ State shall, within the limits of its economic capacity and development, make effective provision for securing the right to work, to educate and to public assistance in case of unemployment, OLD AGE, sickness and disablement and in other cases of underserved want ”.

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32. 32 National Policy For Older Person (NPOP)-1999 O B J E C T I V E S

33. Maintenance and Welfare of Parents and Senior Citizen Act-2007 The act provide for – Revocation of transfer of property by senior citizen in case of negligence by relatives Establishment of old age homes for needy elderly. Provision of geriatric bed and wards in government hospital Facilities like separate queues for senior citizen 33

34. NATIONAL PROGRAMME FOR HEALTH CARE OF THE ELDERLY, MoHFW , Government of India, 2011 34

35. National Programme for Health Care of Elderly (NPHCE) OBJECTIVE- Provide preventive ,curative and rehabilitative services to elderly Promote research on geriatric diseases Human resource development in geriatric health 35

36. VISION NATIONAL PROGRAMME FOR HEALTH CARE OF THE ELDERLY, MoHFW , Government of India, 2011 36

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38. 38 Geriatric Wards (30 Beds) Daily Geriatric Clinic

39. Services provided at level of Subcentre 39

40. Services provided at Primary Health Centre 40

41. Services provided at Community Health Centre Level 41

42. Services provided at level of District Hospital 42

43. Services provided at Regional Geriatric Centres 43

44. Geriatric OPD in Raipur Inaugurated on 1 st October 2018. OPD Facilities provided : Medicine Surgery Obstetrics and Gynecology Orthopedics ENT Ophthalmology Psychiatry 44

45. Other Facilities Pathology Labs (Blood Sample Collection) Biochemistry Lab X-Ray Room ECG Pharmacy 45

46. National Council for Older Person (NCOP) Constituted in 1999 Highest body to advice the government in formulation of policy and programs for the aged Launched in 2000 Action plan for protection of life and property of senior citizen By 2010 ,act was notified by 22 states and all union territories. 46 National Initiative on Care For Elderly (NICE)

47. Up to 90 percent of the project cost is provided to Non- Governmental Organizations for running and maintenance of old age homes, day care centers and mobile medicine units. 47 Integrated Programme for Older Persons (IPOP)

48. Indira Gandhi National Old Age Pension Scheme 48

49. Objective & Assistance Provided 49 Objective : To disburse pension to the destitute old age persons. Assistance provided : Rs. 400/- per month Beneficiary : >65 years of age BPL OR > 60 years & affected with Leprosy / blindness / Insanity / Paralysis / Loss of limb. Other benefits : Clothes twice a year and 2-4 kg of rice per month

50. National Policy on Senior Citizens 2011 Promote the concept of ‘Ageing in Place’ or ageing in own home, housing, income security and homecare services, old age pension and access to healthcare insurance schemes and other programmes and services to facilitate and sustain dignity in old age. 50

51. Indira Gandhi National Widow Pension Scheme 51

52. Objective & Assistance Provided Objective : To disburse pension to the destitute widows. Assistance Provided : Rs 200/- Per month Beneficiary : 40 - 59 yrs of Age BPL widow After they attain the age of 60,they qualify for pension under Indira Gandhi National Old Age Pension Scheme(IGNOAPS ). 52

53. Annapurna Scheme This scheme aims to provide food security to meet the requirement of those senior citizens who, though eligible, have remained uncovered under the IGNOAPS. Under the Annapurna Scheme, 6 Kg wheat and 4 Kg Rice is provided every month to each beneficiary. 53

54. Mukhyamantri Pension Yojna 2018 54 As per this programme , Chhattisgarh Government provide monthly pension to beneficiaries named in Below Poverty Line Card (2011). Sector : Social Welfare Department Beneficiary : 60 years or above Woman 18yrs or above Widow Divorced women Abandoned women in marriage

55. Schemes of Other Ministries 1.Ministry of health and family welfare- Separate queues for olders in government hospital Started geriatric clinic in several government hospital National programme for health care of the elderly(NPHCE) 55

56. 2.Ministry of Railway Separate ticket counters for the elderly. Provision of 40 & 50 percent discount for male & female respectively in all Mails/Express Provision of wheel chairs at stations for the disabled elderly passengers Provision of Lower Berth Quota 56

57. 3.Ministry of Rural development Implementing Indra gandhi national old age pension scheme 57

58. 4.Ministry of Finance Exemption from Income Tax for Senior Citizens of 60 years and above up to Rs. 2.50 lakh per annum. Exemption from Income Tax for Senior Citizens of 80 years and above up to Rs. 5.00 lakh per annum. 58

59. 5.Ministry of Civil aviation Concession in ticket fair up to 50% 59

60. NGOs For Older Person in India HelpAge India Agewell Foundation Maitri GiveIndia India Sponsor 60

61. Old age homes in Raipur Vridha Ashram ( Sanjeevni ) (run by Badhte Kadam),Kota Aashraya , Shyam Nagar (run by Lions Club, Raipur) Government Old Age Home, Mana, Raipur. 61

62. Bapu ki Kutiya Launched on 27 th January 2018 in the Collectorate garden, Raipur. Over 50 attractive hut sheds are being set up in gardens and public places across the state capital exclusively for senior citizens. 62

63. HelpAge India Mission : Work for the cause and care of disadvantaged Older Persons, in order to improve the quality of their lives. Objectives : • To foster the welfare of the aged in India especially the needy aged • To raise funds for projects which assist the elderly irrespective of cast or creed • To create in the younger generation and in society an awareness about the problems of the elderly in India today 63

64. WHO’s global road map on NCDs What is needed for healthy ageing

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66. References Park’s Textbook of Preventive and Social Medicine, 24 th edition. Community Medicine with recent advances, AH Suryakantha , 4 th Edition. Textbook of Community Medicine, Piyush Gupta. Handbook on Social welfare statistics, Ministry of Social Justice and empowerment, GOI, January 2016 World Population Ageing 2015 ,United Nations Department of Economic and Social Affairs ǀ Population Division. NPHCE, Government of India 66

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