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
(2nd 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
1. Introduction
2. Health problems of elderly
3. Preventive measures
4. Health programs and policies related to elderly
4

5. Terminologies
1. Gerontology
2. Geriatrics
3. Preventive Geriatrics
4. Ageing
5. Senescence
6. 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, 24th 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, 24th 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, 24th 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

12. 12

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

16. 16

17. 9.79
4.6
6.66
7.4
7.84
11.21
7.92
8.65
10.24
7.36
7.14
9.48
12.55
7.87
9.88
7.3
4.68
6.25
5.19
9.49
10.33
7.46
6.67
10.41
7.33
7.73
8.87
8.48
6.68
6.35
4.04
4.67
5.75
8.17
9.65
8.58
0 2 4 6 8 10 12 14
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu & Kashmir
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
A & N Island
Chandigarh
D & N Haveli
Daman & Diu
NCT of Delhi
Lakshadweep
Puducherry
India
% of Senior Citizen
States
State wise distribution of elderly population
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
Physical
Psychological
Social
Economical

20. 20
Physical Problems

21. Source : Report on Independent Commission on Health in India
21
88
40
18.7
17.4
16.1
13.3
9
8.5
8.2
0 20 40 60 80 100
Visual Complaints
Locomotor System and Disorders
Neurological Complains
Cardiovascular System
Respiratory System
Skin Conditions
GI Tract
Psychiatric Complains
Hearing Loss
% OF OCCURANCE OF ILLNESS
ILLNESS
Graph showing disease burden among
elders in India

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, 24th 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

27. 27

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
• Includes all measures available to
reduce or limit impairments &
disabilities & minimize suffering
caused by existing disability.
.
• It includes Rehabilitation,
Caretaker Support and
Introduction of support Necessary
to prevent loss of Autonomy.
.

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”.

31. 31

32. 32
Ensure the well-being of the elderly so that they
do not become marginalized, unprotected or
ignored on any count.
• Encourage families to take care of their older
family member
Enable and support NGOs to supplement the care
provided by family
• Provide care and protection to vulnerable
elderly people
Provide adequate health care facility to elderly.
National Policy For Older Person (NPOP)-1999

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
To provide accessible, affordable, and high-quality
long-term, comprehensive and dedicated care
services to an Ageing population
Creating a new “architecture” for Ageing
To build a framework to create an enabling
environment for “a Society for all Ages”
To promote the concept of Active and Healthy
Ageing
NATIONAL PROGRAMME FOR
HEALTH CARE OF THE ELDERLY, MoHFW, Government of India, 2011
36

37. 37
Strengthening of 8 Regional Medical
Institutes.
2 National Centres of aging are
established at AIIMS, New Delhi and
Madras Medical College, Chennai.
Community based PHC approach
including domiciliary visits by trained
health-care workers.
Dedicated services at PHC/Community
Health Centre (CHC).

38. Tertiary
District Hospital
Daily Geriatric Clinic
Geriatric Wards (10
Beds)
CHC/PHC
Geriatric OPD on fixed days
Sub Centre
Home Based Care
38
Geriatric Wards (30
Beds)
Daily Geriatric Clinic

39. Services provided at level of Subcentre
39
Health Education related
to Healthy ageing.
Domiciliary visits for
attention and care to home
bound / bedridden elderly
persons

40. Services provided at Primary Health Centre
40
Weekly geriatric clinic run by a trained Medical
Officer
Maintain record of the Elderly
Referral for diseases needing further investigation
and treatment.
Conducting a routine health assessment of the
elderly persons

41. Services provided at Community Health Centre Level
41
Geriatric Clinic
twice a week.
Rehabilitation Unit
for physiotherapy and
counselling
Domiciliary
visits
Health promotion and
Prevention
Referral of difficult cases to
District Hospital/higher
health care facility

42. Services provided at level of District Hospital
42
Geriatric Clinic for regular dedicated OPD services to
the Elderly
Facilities for laboratory investigations for diagnosis.
Ten-bedded Geriatric Ward for in-patient care of the
Elderly
Provide services for the elderly patients referred by the
CHCs/PHCs etc
Referral services for severe cases to tertiary level
hospitals

43. Services provided at Regional Geriatric Centres
43
Geria
-tric
Clinic
30-bedded
Geriatric
Ward for in-
patient.
Labora-
tory
investigati
ons
Tertiary
health care to
the cases
referred from
medical
colleges,
district
hospitals

44. Geriatric OPD in Raipur
• Inaugurated on 1st 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
4
5

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
5
4
• 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 27th 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 NCDsWhat is needed for healthy ageing

65. 65

66. References
• Park’s Textbook of Preventive and Social Medicine, 24th
edition.
• Community Medicine with recent advances, AH Suryakantha,
4th 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

67. 67