Need for a safety net, the Hindu India, by Hendi Lingiah

THE HINDU

Online edition of India's National Newspaper
Sunday, Sep 21, 2008

HENDI LINGIAH

As we become an ‘ageing country’, there is an urgent need for an accurate public health policy in the senior care field.

Challenges ahead: To provide organised healthcare for the elderly.
The percentage of persons aged above 60 in India has been rising steadily over the last decades. In fact, in 2001, its proportion exceeded 7.5 per cent, defining a country as an “ageing country” according to the U.N. definition and is exp ected to reach 8.9 per cent in 2016. But the increase of life expectancy goes with the increase of age-related diseases and developing countries are not spared. The number of people above the age of 60, suffering and searching for care, domiciliary services, specific treatments and specific answers to their needs will increase. Consecutively, the lack of specific structures would lead to discontent. Hence the need to implement a sound public health policy in the field of senior care.

Today, it is estimated that more than 50 per cent of people with Alzheimer’s Disease live in developing countries. Meanwhile, when developed countries have more care alternatives available for a less number of elderly people, they are also trying to improve the current public health system with the aim of anticipating their growing ageing population.

My interest in Alzheimer’s Disease started when I joined an NGO established in the field of senior citizen’s welfare, well known at that time for opening a township for retired people wishing to live an autonomous and still active retreat. This township included a small structure devoted to elderly people affected by Alzheimer’s Disease. It was a nice residential set-up of eight comfortable rooms with bathroom and one common activity room; it was located in a rural part of India. That premise needed to be developed and enhanced; routine, assessments and residents’ health care, even material aspects, had to be looked after.

Thoughtful set-up

We started working with doctors and psychiatrists and in cooperation with them and the team we did the follow-up of patients, the interviews with families, the local staff supervisions… It was an interesting professional experience; it broadened my mind and my interest in the field of ageing and Alzheimer’s Disease and implementing a psycho-social care approach in a 24x7 small residential setting for patients suffering from AD. But above all, it was about making this place a comfortable and enjoyable home for the frail elderly, maintaining as long as possible their abilities and a community life.

Back in France, I’ve stayed connected with the senior care field in India. These days, it seems to me that ageing and care for the elderly have really become an issue for the people and the institutions of the country. For instance, the training provided by the National Institute of Social Defence and supported by the Ministry of Social Justice and Empowerment shows a commitment from the government to face that challenge. Hopefully, with the joint effort of the Ministry of Health and the Ministry of Social Justice and Empowerment, the government will maintain a constant pace, be vigilant to elder abuse, set-up official guidelines and implement strict standards in the care of elderly people.

A necessity

Properly planning and the implementation of a public health policy regarding support for the elderly has today become a necessity: the recognition of the early symptoms of dementia, patterns of interventions, research on the diseases, drug and non-drug therapies, infrastructures, professional practices, home caregivers trainings…

This is the challenge for developing countries, if they want to avoid, in the coming years, the increase in the number of sick elderly persons and severe cases due to insufficient early detection and solutions provided at an affordable cost.

The author is an AARDSI member and a clinical psychologist in France.