Increased human life span as witnessed in thepreceding decades has not been accompanied by good quality of life for majority of older Indians. Of the many determinants of the quality of life: financial security, emotional security and health and wellbeing, the last
one occupies the prime position, as all other issues become irrelevant in poor health. Research in social gerontology and geriatrics in past decades have provided insight into various aspects of the status of older people in India.
Large volume of authentic data on demographic trends, impact of changes in the family structure and migration, physical and behavioral status, organization and dynamics of health systems exist in Indian literature. However, very little effort has been made to develop a model of health and social care in tune with the changing need and time. As no model for older people exists in India, as well as most other societies with similar socioeconomic situation, it may be a challenge as well as an opportunity for innovation in health system development. This is a major challenge because: i) no clear policy or strategy for development of health care of older people exists, ii) there are differences in opinion whether there is a need for such segregation; iii) there is dilemma about the most effective way of satisfying the health needs of the elderly and iv) there is no unanimity regarding minimum knowledge and skills required in the curriculum of health professionals.
It is often simplistically considered that health problems in old age are a constellation of problems such as increased susceptibility to infection, inability to cope with physical and psychological stress, degenerative arthritis, atherosclerotic and vascular diseases of heart and brain, cancer of various organs and cognitive impairment due to declining brain size or more importantly various types of cognitive disorders.
However, data from focused academic research as well as three nationwide sample surveys of 1986-1987,1995-1996 and 2004 reveal that the magnitude and nature of diseases and disabilities of old age may be much more than what has been summarized in the previous statement. How the society has to face the challenge? A strategy is the need of the hour. The components of the old age care strategy could be iterative process of policy and strategy formulation, focus on primary health care, age friendly health systems, strong participation of the older population in society, development of human resources for quality health care, creation and maintenance of multidisciplinary networks to facilitate care of the elderly, research, surveys and studies for establishment of a database for evidence-based care and raising the awareness of the population to active ageing.
Health in old age is affected by social and economic issues apart from the inherent disadvantage of the biological decline. The aim of health care of older people is to provide quality services closest to their home, to keep them functional, and to help them return to normal life in community from hospital as soon as possible after illness. The health system which cares for older people must have full knowledge of its users like their financial status, social and cultural resources and living arrangements, apart from other disadvantages they may be facing. The care provided should be tailored to meet each individual’s needs. A comprehensive care package that includes promotive, preventive, curative and rehabilitative services is essential for this population group. Easy accessibility, continuity and good quality of care only can earn respect and satisfaction of these consumers. A high degree of coordination is essential in such a model so that different services do not function at cross-purposes but are complementary to each other.
Most importantly, the services should be complete in terms of physician consultation, paramedical services, drugs and restorative interventions. The design of services for older people has been an object of debate in most developed countries. Till now, no consensus has been reached whether these services should be age based or need based. What would be ideal: to have all people above the age of 60 to be cared by the services or only those people with multiple disabilities to be included in the system? For a society like ours, probably a balanced mix of both these models should be more pertinent and of great value.
Long-term care is the system of activities undertaken by informal caregivers (family, friends, and/ or neighbours) and/or professionals (health, social & others) to ensure that a person who is not fully capable of self-care can maintain the highest possible quality of life, according to his or her individual preferences, with the greatest possible degree of independence, autonomy, participation, personal fulfilment and human dignity.
Long term care for older person in India has always been a matter of family functioning. Currently, no old age home or senior citizen accommodation provides shelter to older people with mental and physical disability requiring assistance in activities of daily living and intense nursing care. Irrespective of economic status the care givers of such individuals undergo great stress in caring such disabled relatives and also lead their own lives. Older people living alone without any surviving caregivers also need long term care at some point of time or the other. The plight of large majority of older individuals by and large remains unnoticed. Out-of-box thinking is essential to create a provision of long term care funding in India. This includes creation of a trust to receive funds from diverse sources and utilize them for people in need of long term care. Indian Ageing Congress will be a platform for developing out-of box ideas. Some of the abstracts from younger scholars are interesting and may provide cues for intellectual debate as well as programme development; thus the theme: “moving from awareness to action”.
Wednesday, March 10, 2010
CARING FOR THE AGED, OLD PEOPLE - COPING WITH THE ELDERLY, SENIOR CITIZENS
Caring for the elderly at is hard for all because, in taking care of old people, senior citizens and carers of the aged are not understood by families of aged persons.
Taking care of the elderly, caring for old people, especially if caring for the aged personally, often needlessly causes hurt to persons caring for old people or to the elderly or both, to carers of aged persons and to old persons -more so where the elderly are not ill old people but healthy senior citizens, and where loved ones care for the aged. But hurt in old age, upset to the carer of an old person can be avoided. Here is how to care for the elderly.
In coping with old people issues, avoidance of hurt to the elderly and upset to those taking care of the aged, begin with appreciating the aged and those caring for the elderly.
The care of the elderly in extreme cases of old age not common to old people aside, the old age of senior citizens need not be a problem in caring for aged persons -neither to aged persons nor to those caring on behalf of the families of the aged, if the following tips on how to take care of the elderly are kept in mind by persons caring for the aged, and by the families of old people and of those caring for the elderly.
In caring for the elderly the first problem is not the elderly, but unawareness of the persons taking care of the elderly of the appreciation by those for whom also old people are cared for -that the family of the old person do appreciate the regular attendance to that old person ~more so if the care of the elderly is by one only of the members of the family of the aged; the occasional 'How are you coping?' by the relatives of the elderly is morale boosting to those caring for aged persons.
Other problems in caring for the elderly which both the old people and carers for the aged have fall into three categories, below, arising from assuming that old age means physically and/or mentally weak, which old age does not make the elderly and most old people enjoy good health, many of the aged continuing to work after they have become senior citizens.
The status enjoyed by old persons before their old age is important to old people; the elderly must not be treated as children: the aged expect their privacy to be respected, also not to be excluded from family discussions -it hurts the dignity of old people needlessly to be spoken to loudly or slowly or be ignored and causes resentment by the elderly.
Aged persons do not cease to like activity; old fashioned habits and interests of the aged must not be made light of: many old people are young in heart and outright rejection of help offered by the aged, limiting old age pass-times, objecting to elderly friends, annoy old people -older people, seniors, don't like it.
Crises in old age affecting also those caring for old people and the families of the aged mostly is due to inadequate consultation with the elderly: if old persons are to be subjected to change of environment or arrangements, consult and prepare them -taking it for granted that the elderly will adjust causes confrontation.
Treat old people normally and thank those who have undertaken the taking care of the elderly.
Taking care of the elderly, caring for old people, especially if caring for the aged personally, often needlessly causes hurt to persons caring for old people or to the elderly or both, to carers of aged persons and to old persons -more so where the elderly are not ill old people but healthy senior citizens, and where loved ones care for the aged. But hurt in old age, upset to the carer of an old person can be avoided. Here is how to care for the elderly.
In coping with old people issues, avoidance of hurt to the elderly and upset to those taking care of the aged, begin with appreciating the aged and those caring for the elderly.
The care of the elderly in extreme cases of old age not common to old people aside, the old age of senior citizens need not be a problem in caring for aged persons -neither to aged persons nor to those caring on behalf of the families of the aged, if the following tips on how to take care of the elderly are kept in mind by persons caring for the aged, and by the families of old people and of those caring for the elderly.
In caring for the elderly the first problem is not the elderly, but unawareness of the persons taking care of the elderly of the appreciation by those for whom also old people are cared for -that the family of the old person do appreciate the regular attendance to that old person ~more so if the care of the elderly is by one only of the members of the family of the aged; the occasional 'How are you coping?' by the relatives of the elderly is morale boosting to those caring for aged persons.
Other problems in caring for the elderly which both the old people and carers for the aged have fall into three categories, below, arising from assuming that old age means physically and/or mentally weak, which old age does not make the elderly and most old people enjoy good health, many of the aged continuing to work after they have become senior citizens.
The status enjoyed by old persons before their old age is important to old people; the elderly must not be treated as children: the aged expect their privacy to be respected, also not to be excluded from family discussions -it hurts the dignity of old people needlessly to be spoken to loudly or slowly or be ignored and causes resentment by the elderly.
Aged persons do not cease to like activity; old fashioned habits and interests of the aged must not be made light of: many old people are young in heart and outright rejection of help offered by the aged, limiting old age pass-times, objecting to elderly friends, annoy old people -older people, seniors, don't like it.
Crises in old age affecting also those caring for old people and the families of the aged mostly is due to inadequate consultation with the elderly: if old persons are to be subjected to change of environment or arrangements, consult and prepare them -taking it for granted that the elderly will adjust causes confrontation.
Treat old people normally and thank those who have undertaken the taking care of the elderly.
The old age problems and care of senior citizens
The dream of the people all over the world to live long is now becoming a reality due to the advancement in socio economic development and sciences, particularly medical sciences. It is estimated that there are 416 million old people (aged 60 years and above) around the globe and by 2020 world's 11.9% of population will be above 60 years. In India also the trend is same, 7.5% of the total population is above 60 years and the life expectancy is increasing gradually.
Healthy ageing is not only related to the advances in medical technology but also related to the interaction of a wide range of social factors such as maintaining and enhancing physical and cognitive functions being fully involved in the society, leading a stimulating and productive life, living in a stable social environment and having meaningful personal relationships.
The diminishing joint family system in India and the various other social factors created a boom in emergence of old age homes, especially in cities. Various surveys done in India and abroad have confirmed that most of the elderly people consider home as a place where they can derive greatest emotional satisfaction. Elder abuse is one of the subjects of frequent discussion these days, whether it is institution based or community based. Elder abuse is not merely physical instead there are mainly five categories- physical, emotional, financial, neglect and sexual.
The care givers ie, along with whom the elderly is staying in the home is indirectly or directly responsible for the abuse of elders in their home. Population ageing creates a new problem ie., a growing breed of care givers who are themselves in need of care. Hence, this author felt that it is vital to assess the existing knowledge and reinforce the same to improve the quality of life of the elderly.
Healthy ageing is not only related to the advances in medical technology but also related to the interaction of a wide range of social factors such as maintaining and enhancing physical and cognitive functions being fully involved in the society, leading a stimulating and productive life, living in a stable social environment and having meaningful personal relationships.
The diminishing joint family system in India and the various other social factors created a boom in emergence of old age homes, especially in cities. Various surveys done in India and abroad have confirmed that most of the elderly people consider home as a place where they can derive greatest emotional satisfaction. Elder abuse is one of the subjects of frequent discussion these days, whether it is institution based or community based. Elder abuse is not merely physical instead there are mainly five categories- physical, emotional, financial, neglect and sexual.
The care givers ie, along with whom the elderly is staying in the home is indirectly or directly responsible for the abuse of elders in their home. Population ageing creates a new problem ie., a growing breed of care givers who are themselves in need of care. Hence, this author felt that it is vital to assess the existing knowledge and reinforce the same to improve the quality of life of the elderly.
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