- The elderly population in India is growing rapidly due to increased life expectancy and will nearly triple between 2001 and 2051. Currently, most elderly live in rural areas and have high rates of poverty and illness. - Family structures are changing from joint to nuclear families, leaving many elderly without adequate familial support. Geriatric healthcare services in India are underdeveloped and most hospitals lack special facilities for elderly patients. - The government has established policies to promote eldercare and support through programs like subsidizing old age homes and day care centers. However, geriatric nursing training and facilities remain limited. Non-governmental organizations have an important role to play in filling gaps.

1. ELDERLY CARE INELDERLY CARE IN
INDIA-CHANGINGINDIA-CHANGING
PERSPECTIVESPERSPECTIVES
MR. SANJAY DABHIMR. SANJAY DABHI
LECTURER, GOVT. CON, SURATLECTURER, GOVT. CON, SURAT

2. TRADITION SPEAK…
One who always serves and respects elderly
is blessed with four things : Long Life,
Wisdom, Fame and Power”
Manusmriti Chapter 2:121

3. Worldwide Trend of Population of
60 Years and Above : 1980-2020
1980 1990 2000 2010 2020
World 381.2 484.7 608.7 754.2 1011.6
Developed 173.3 203.6 234.6 232.4 308.2
Developing 207.9 281.8 374.1 491.8 703.4
Africa 23.4 30.9 41.8 57 82
Latin America 23.4 31.7 41.9 56.4 80.7
Asia (excl. Japan) 160 218.2 290 377.7 539.9
China 78.6 101.2 131.7 167.9 238.9
India 44.6 60.2 81.4 107 149.7
United Nations,World Demographic Estimate and Projections

4. Proportion of Aged 60 and
Over Population (in Per cent)
1980 1990 2000 2010 2020
World 8.6 9.2 9.9 10.8 12.9
Developed 15.2 16.8 18.4 19.7 22.4
Developing 6.3 7 7.7 8.7 10.9
Africa 4.9 4.8 4.8 4.9 5.6
Latin America 6.5 7 7.7 8.8 11
Asia (excl. Japan) 6.5 7.4 8.5 9.8 12.8
China 7.4 9 10.5 12.4 16.6
India 6.5 7.3 8.4 9.9 12.6
United Nations,World Demographic Estimate and Projections

5. Elderly Population-Facts!
• Aging of population is an end product of
demographic transition.
• The number of elderly people in developing
countries is almost 3-4 times of that of
developed countries.
• The developed countries have already
experienced the consequences of this
transition.

6. Elderly Population-Facts!
• World population of 6.1 billion at the
dawn of 21st
century is likely to
become 9.3 billion in 2050 (UN
2004).
• Global aged population from 595
million to 2 billion – a four fold rise-
by 2050!
• In terms of proportion -10% in 2000,
15% by 2025, rising to 21.6% by
2050.

7. Elderly Population-Facts!
• 73 % of deaths in the elderly are
related to heart diseases, smoking
and cancers.
• 20% of doctor’s visits, 30 % of
hospital days and 50% of bedridden
days are ascribed to elderly patients.
• ‘Expansion of morbidity’ even though
increased life expectancy due to
chronic non-communicable diseases.

8. Elderly in India -Facts!
• 24 million in 1961 increased to 77
million in 2001
• Projected to rise to 179 million in
2031 and 301 million in 2051.
• 70 and above projected to increase
from 29 million in 2001 to 132 million
in 2051.
• 80+ would be fastest to grow – 8
million in 2001 to 32 million in 2051.

9. Elderly in India -Facts!
• 2nd
largest elderly (60+) population in
the world (2001)
• 80% are in rural areas
• 40% are below poverty line
• over 73 per cent are illiterate.
• about 90 % of the old people have no
official social security (i.e., without
PF, Gratuity and Pension etc).

10. Elderly in India -Facts!
• Life expectancy 31.7 years in 1941
increased to 60.5 years in 2000.
• 55% of the women of 60 years and
above are widows.
• Older women most vulnerable.
• Elderly poverty is a major risk of
ageing in developing countries.

11. Not just the numbers…
• Family structure is changing to
nuclear/small unit families.
• Without the safe, secure and
dignified status in the family, the
elderly are finding themselves
vulnerable.
• Welfare of the elderly has been a
low priority with the state…

12. Distribution of Aged Persons by
State of Economic Dependence
(n=1000)
Not
Dependant
Partially
Dependant
Fully
Dependant
No
Response
Rural
Male 485 180 313 22
Female 121 146 706 27
Urban
Male 515 169 297 19
Female 115 110 757 18
National Sample Survey 52nd Round Survey, 1995-96

13. Distribution of Care Provider of
Economically Dependent Aged
Spouse
Own
Children
Grand
Children
Others
Rural
Male 113 766 50 71
Female 159 717 52 72
Urban
Male 105 792 54 49
Female 182 695 56 67
National Sample Survey 52nd Round Survey, 1995-96

14. The Support…
• The major thrust has been on
improving the health status of
children and women
• Geriatric services are largely
unorganized.
• There are 186 old age homes, 233
day care centers and 28 medical vans
• These are managed by NGO/network
of PHC and subentries in the rural
areas.

15. Geriatrics in India
• Most hospitals do not have a special
geriatric facility. At present most elderly
patients are still being treated in general
medical wards.
• There is only one hospital in Chennai that
gives post-graduate (M.D.) education in
geriatric medicine!
• Similarly the nursing and other para-
medical staff are not formally trained in
providing care for elderly patients.

16. Distribution of Chronic
Diseases in Aged (n=1000)
India
Rural
Urban
Chronic Disease M F M F
Cough 250 1958 179 142
Piles 33 16 32 18
Joint Problems 363 404 285 393
High/low BP 108 105 200 251
Heart Disease 34 27 68 53
Urinary Problem 38 23 49 24
Diabetes 36 28 85 66
Cancer 2 3 2 4
Any of the above 527 514 528 560
National Sample Survey 52nd Round Survey, 1995-96

17. Distribution of Physical
Disability in Aged (n=1000)
India
Rural
Urban
Disability M F M F
Visual 249 291 225 260
Hearing 139 156 111 132
Speech 32 38 29 3
Locomotor 107 115 80 94
Amnesia/Senility 96 113 61 80
Any Disability 380 425 333 367
National Sample Survey 52nd Round Survey, 1995-96

18. The policy Initiative in India
• 1999 Indian Government announced a
National Policy on Older Persons
• policy implementation is to be monitored
by National council for Older Persons
(NCOP).
• joint responsibility of the state and
Central governments
• in December 2007 Indian parliament has
passed a bill known as Maintenance of
parents and Senior citizens Act

19. Policy aims to….
• to encourage geriatric units in
hospitals and clinics
• infirmary care units
• emphasis on family care of the aged
through incentives and schemes for
the needy families
• promotion of values through formal
education and media
• subsidizing old age homes and day
care centers

20. Geriatric Nursing Care
Workshop (November ’07)
• In collaboration with NICE/ICCE
• 5 day workshop
• Attended by nursing staff of
different hospitals in the state of
Rajasthan, India.

21. Aims of the Workshop…
• Provide improved ideas and practices
in the Care of elderly
• Refine existing practitioner’s skill in
the care of elderly
• Draw attention of general
practitioners to the needs of care of
elderly
• Positively influence Government
policy initiatives on geriatric care

22. Indian Gerontological Association
www.gerontologyindia.com
• Established in 1968
• Devoted to well being of Senior
citizens & research on ageing
• Indian Journal of Gerontology -1969
• Affiliated to IAGG in 1971

23. Indian Gerontological Association
• Runs a Day Care Centre
• Runs a counselling centre for elderly
• Organises training for family care givers
• Organises lectures on diseases common in
old age
• Consultancy for NGOs working for elderly

24. In Summary…
• Elderly population in India is increasing.
• Status of elderly changing in family.
• Geriatrics is in incipient stage.
• NGOs have important role to play in
creating awareness, imparting information
and training of support services.
• We need to learn from the model of
geriatric care in the developed countries.

25. THANKS