A formal approach to homes for the elderly is an important policy and planning issue for India
A formal approach to homes for the elderly is an important policy and planning issue for India
As India becomes increasingly urbanized and families are divided into smaller units, homes have become for the elderly. The care of older people is managed by a group of professionals or voluntary organizations interested in geriatric services. The number of such care homes is increasing rapidly in urban and semi-urban India. These homes are either paid for, or provide free or subsidized service. Typically, such homes are run by NGOs, religious or voluntary organizations with the support of the government or by local philanthropists. They provide accommodation, timely care and a sense of security for their residents. However, service quality varies because these homes lack regulatory oversight. Many homes lack clearly established standard operating procedures, and their referral paths to health care are informal. There is an urgent need to understand the quality of life in such institutions, including the impact of these homes on the mental health of their residents.
fast growing class
A formal approach to homes for the elderly is an important policy and planning issue for India. The World Population Aging Report of the United Nations states that India’s aging population (aged 60 years and above) is projected to increase from about 8% to about 20% by 2050. By 2050, the percentage of older people will increase by 326%, with those aged 80 years and above increasing by 700%, making them the fastest growing age group in India. With this future in mind, it is essential that our policy framework and societal responses are geared to meet this reality.
A recent set of research papers from Hyderabad focusing on the quality of health in homes for the elderly has some interesting insights. The papers highlight the fact that good intentions and a sense of charity are often inadequate when it comes to meeting the basic health needs of their elderly residents. This paper L.V. These are the results of the Hyderabad Ocular Morbidity in Elderly Study (HOMS) by Prasad Eye Institute which was primarily intended to understand the vision needs of elderly residents of such homes. About 30% of the residents who were part of the study (more than 1,500 participants from 40 households) had some kind of vision loss, but about 90% of this vision loss can be addressed by simple, relatively low-cost health interventions: Issuing better glasses or cataract surgery.
The study also found some ‘overlooked’ effects of vision loss: many suffered from depression. In fact, people with both vision and hearing loss had rates of depression five times higher than those without. Our homes, buildings and social environments are not designed with the elderly (or people with disabilities) in mind. As people age, and their motor skills weaken, they are at greater risk of falling down and injuring themselves. Loss increases this risk. Instead of planning accessible and elderly-friendly structures that allow them to operate safely, we reduce their mobility. People with functional skills are asked to abstain from daily tasks such as cooking, sewing, cleaning or washing. This reduces their sociability, their independence and sense of well-being – all of which lead to mental health issues and depression.
The state of homes for the elderly today offers us some low-hanging fruits that we can easily address: creating a formal route for basic health checkups between such homes and public health facilities. This may include checking blood sugar, blood pressure, periodic vision and hearing tests, and a simple questionnaire to assess mental health. Such interventions are cheap (think of all the screening of motorcyclists outside public grounds for morning walkers) and can go a long way in identifying health issues and providing support. The next step will be to create formal pathways to address any health problems that such screening identifies. Many hospitals (public, NGO-run, and private care) can help.
public policy support
However, strong public policy will be needed to support homes for the elderly. Health institutions will also need to offer a comprehensive set of packages that are designed for the elderly – not piecemeal solutions for diabetes, cardiology or cancer, for example. What happens once care is provided? Elderly homes should be re-guided by policy to make their facilities, buildings and social environments elderly- and disabled-friendly. Design, architecture and civic amenities have to be thought through from the start – and these innovations should be available to all residents, not just expensive ones. There are lessons here for society as a whole, but, as they say, let’s take it one step at a time.
Teja Balantarapu Associate Director, Science, Health Data and Story Telling, L.V. Prasad Eye Institute is; Srinivas Marmamula, Associate Director, Public Health Research and Training, L.V. Prasad Eye Institute is