Recent trends in Geriatrics and Gerontological Studies - State Level Conference

To conclude, in this respect, the National Plan on Gerontology is of substantial importance and needs to e incorporated in this work.

1. With advancing age, old persons have to cope with health and associated problems some of which may be chronic, of a multiple nature, require constant attention and carry the risk of disability and consequent loss of autonomy. Some health problems, especially when accompanied by impaired functional capacity; require long term management of illness at time and of nursing care.
2. Health care needs of older persons are to be given high priority. The goal should be good affordable health services, very heavily subsidized for the poor and a graded system of user charges for others. It will be necessary to have a judicious mix of public health services, health insurance, health services provided by not for profit organizations including trusts and charities amid private medical care. While the first of these will require greater State participation, the second category will need to be promoted by the State, the third category given some assistance, concessions and relief, and the fourth encouraged by subjected to some degree of regulation, preferably by an association of providers of private care.
3. The primary health care system will be the basic structure of public health care. It will be strengthened and oriented to be able to meet the health care needs of older persons as well as the public health services, preventive, curative, restorative and rehabilitative, will be considerably expanded and strengthened and geriatric care facilities provided at secondary and tertiary levels. This will imply much larger public sector outlays, proper distribution of services in rural and urban areas and much better health administration and delivery systems.
4. The development of health insurance will be given high priority to cater to the needs of different income segments of the population and have provision for varying contributions. Various reliefs and concessions will be given to health insurance to enlarge the base of coverage and make them affordable.
5. Trusts, charitable societies and voluntary agencies will be promoted, encouraged and assisted by way of grants, tax relief and land at subsidized rates to provide free beds, medicines and treatment to the very poor elder citizens and reasonable user charges for the rest of the population.
6. Private medical care has expanded in recent years offering the latest medical treatment facilities to those who can afford it. Where land and other facilities are provided at less than market rates, bodies representing private hospitals and nursing homes will be requested to direct their members to offer a discount to older patients. Private general practitioners will be extended opportunities for orientation in geriatric care.
7. Public hospitals will be directed to ensure that elderly patients are not subjected to long waits and visits to different counters for medical tests and treatment. They will endeavor to provide separate counters and convenient timings on specified days. Geriatric wards will be set up.
8. Medical and para-medical personnel in primary, secondary and tertiary health care facilities will be given training and orientation in health care of the elderly. Facilities for specialization in geriatric medicine will be provided in the medical colleges. Training in nursing care will include geriatric care. Problems of accessibility and use of health services by the elderly arise due to distance, absence of escort and transportation. Difficulties in reaching a public health care facility will be addressed through mobile health services, special camps and ambulance services by charitable institutions and not for profit health care organizations. Hospitals will be encouraged to have a separate Welfare Fund which will receive donations and grants for providing free treatment and medicines to poor elderly patients.
9. For the old who are chronically ill and deprives of family support, public charity and voluntary organizations will be necessary. These are also needed to cater to cases of abandonment of chronically ill aged patients admitted to public hospitals.
10. Assistance will be given to geriatric care societies for the production and distribution of instruction material on self care by older persons. Preparation and distribution of easy to follow guidance material on health and nursing care of older persons for the use of family care givers will also be supported.
11. Older persons and their families will be given access to educational material on nutritional needs in old age. Information will be made available on the foods to avoid and the right food to eat. Diet recipes suiting tastes of different regions which are nutritious, tasty, fit into the dietary pattern of the family and the community, are affordable and can be prepared from locally available vegetables, cereals and fruits will be disseminated.
12. The concept of healthy ageing will be promoted. It neither is necessary to educate older persons and their families that diseases are not a corollary of advancing age nor is a particular chronological age the starting point for decline in health status On the contrary; preventive health care and early diagnosis can keep a person in reasonable good health and prevent disability.
13. Health education programs will be strengthened by making use of mass media, folk media and other communication channels which reach out to different segments of the population. The capacity to cope with illness and manage domiciliary care will be strengthened. Programs will also be developed targeting the younger and middle age groups to inform them how life styles during early years affect health status in later years. Messages on how to stay healthy for the entire life span will be given. The importance of balanced diets, physical exercise, regular habits, reduction of stress, regular medical check up, allocation of time for leisure and recreation and pursuit of hobbies will be conveyed. Programs on yoga, medication and methods of relaxation will be developed and transmitted through different channels of communication to reach diverse audiences.
14. Mental health services will be expanded and strengthened. Families will be provided counseling facilities and information on the care and treatment of older persons having mental health problems.
15. Non-governmental organizations will be encouraged and assisted through grants, training and orientation of their personnel and various concessions and relief to provide ambulatory services, day care and health care to complement the efforts of the State.