Health of senior citizens

Author: 
Dr. Arun Mitra

According to the law, a ‘senior citizen’ means any person being a citizen of India who has attained the age of sixty years or above. Population Census 2011 revealed that there are nearly 104 million elderly persons (aged 60 years or above) in India; 53 million females and 51 million males. A report released by the United Nations Population Fund and HelpAge India suggests that the number of elderly persons is expected to grow to 173 million by 2026. Both the share and size of elderly population is increasing over time. From 5.6 percent in 1961 the proportion has increased to 8.6 percent in 2011. Out of this 71 percent of elderly population resides in rural areas while 29 percent is in urban areas. In rural areas, 66 percent of elderly men and 28 percent of elderly women were working, while in urban areas only 46 percent of elderly men and about 11 percent of elderly women were working. In the age - group of 60 - 64 years, 76 percent persons were married while 22 percent were widowed. Remaining 2 percent were either never married or divorced. (Source: Elderly in India 2016)
This period of life is full of challenges. With growing age, physical capacities come down. Mental faculties too start facing a downward trend. The person is more prone to fall prey to various types of diseases. Most of these diseases are of degenerative nature and thus chronic in type. The list of the risks of old age, including illnesses, disorders, ailments, maladies, and diseases associated with old age is quite long. Through various researches around 125 diseases have been identified to be directly connected with this age group, some of the important and more challenging illnesses need to be taken care of on priority basis. Diseases affecting heart, chest and nervous system are more common.
Arthritis is a very common condition that the older people suffer from. It can lead to pain in the joints, lowering the quality of life by prohibiting day to day activity and movements of the person. It may be fatal in a little number of cases because of complications arising out of this but the declining quality of life seriously affects physical and mental status of a person.
Heart diseases are the leading killers of persons above the age of 65. One needs to get the heart monitored time to time to get to know any disease cropping up well on time. This needs awareness and has financial implications as well.
Cancer is the second leading cause of death. This incapacitates the person, who has to pay repeated hospital visits requiring expensive investigations, monitoring and medical or surgical intervention for long period of time. All this seriously affects the economy and psychology of the person. The whole family is put into extreme stress. Depression is one of serious issues associated with it.
Respiratory diseases are the third common cause of death among elderly who are more vulnerable to pneumonia and other infections. Many of them in this age group develop chronic, obstructive pulmonary disease (COPD) which requires repeated hospitalization and intensive treatment.
Cerebrovascular accidents occur as a result of leakage or clotting of blood in brain or tumors in the cranium. Person may develop paralysis. The quality of life becomes very poor and the patient becomes dependent on others. This becomes a cause of serious psychological disturbance and a matter of stress for the whole family.
Parkinsonism hampers a person’s capabilities and gradually cripples the physical capacities.
Alzheimer’s disease occurs because of degenerative process of the brain and the patient develops cognitive impairment and is unable to take care of himself. He is a concern to the family for safety and cost involved.
Osteoporosis makes bones brittle and the person is more likely to develop fracture of any bone. But the vertebral bodies fracture leading to their collapse can cripple the patient. Falls are more common and these are emergency conditions which may lead to fractures and hospitalization.
Infections occur more commonly in this age group because of lowering of resistance. Sometimes these may prove to be fatal.
Depression is an increasing problem in our country, which is occurring as a result of changing family relations, increase in cost of healthcare, physical incapacities that increase with the age and person’s dependence on his siblings. Losing one’s life partner causes loneliness and isolation leading to depression.
Poverty affects senior citizens’ health. Older women are slightly more likely than men to be living in poverty, and that gap widens in those over 80. Single older adults are also significantly more likely to live alone with fewer resources.
Elderly age is a challenging period in one’s life. It is not easy to accept that one has now to be dependent on children for many day to day needs. Financial deprivation adds to the difficulties. The situation gets worse if the family is uncaring and neglecting the elderly. In our country where the social security net is very poor, elderly people face great difficulties as far as healthcare is concerned. To ameliorate the situation several steps have to be taken. Elderly need compassion. They need emergency care - sometimes repeatedly. Health care of the elderly has to be designed accordingly. (IPA/The author is a leading ENT specialist based in Ludhiana. He is the Senior Vice-President of Indian Doctors for Peace and Development (IDPD) and a member of the core committee of Alliance of Doctors for Ethical Healthcare in India)

Wednesday, 13 September, 2017