Chennai, September 22, 2012: “Geriatric care should be the highest priority of India, which is undergoing a demographic transition with falling mortality and fertility rate, and the ageing population – people over 65 years old – is expected to grow from about 7% in 2010 to 16% in 2050,” said Dr Andrew Elder, Consultant Physician in Geriatric Medicine, Western General Hospital, Edinburgh, UK, while urging the policy makers to act now and plan to develop capabilities to meet the future needs and avoid adverse economic, and social implications that many developed countries like UK face due to poorly developed healthcare policies for elderly.
Delivering the 10th MV Arunachalam Endowment Oration here today on “Eighty not out?’ “Challenges of the silver innings”, organized by The Institute of Neurological Sciences, Voluntary Health Services, here today, Dr Elder, who is also the international expert adviser to the Hong Kong Health Authority on Geriatric Medicine, urged the Indian policy makers to build a multi-professional team to provide a comprehensive geriatric assessment and treatment taking into account diseases, symptoms, and support dependency needs of elderly, over 50% of who have more than one disease – and about 30% of people over 80 years are confined to their houses in India.
“Instead of taking patient to elderly medicine, providers should take elderly medicine to the patients, wherever they are and treat acute illnesses, care for irreversible diseases and dependencies, prevent preventable diseases like cataract, minimize effects of chronic illnesses, and care for the dying, from within the specialty boundaries,” he suggested.
Dr Elder said that though geriatric medicine has already been the single biggest specialty in countries like UK, only one medical college in India, among 206-odd medical colleges, right now has a full time geriatric MD programme. Citing a recent survey done in India, he said that about 50% of senior level students from medical, nursing, and social work disciplines were unaware of policies related to health of elderly and none demonstrated recognizable knowledge of clinical and functional implications of ageing.
According to him some of the other key challenges India faces in providing geriatric care include: the need for expanding the provider boundaries by joining services of health and social care sectors, hospitals, community, private, public and voluntary sectors; building geriatric care services in all specialty boundaries like cardiology, neurology, etc; equal investment in both community-based primary and hospitals-based secondary care when it comes to addressing the need for acute care of elderly; and equal investment in domiciliary and institutional care, when it comes to providing long term care for the elderly.
India’s dependency ratio, proportion of population depending on others, which is a key determinant of economic output, is on the rise. But social factors like fewer children in each family, increased employment opportunities for women, who were traditionally taking care of the old in India, rapid urbanization and family fragmentation, would make it difficult to provide health care to elderly with respect. At the community level, India needs to create people to provide expert care to old people with permanent or temporary loss of independence, he observed.
Dr Elder stressed the need for people to have a more positive attitude towards old people. “Ageing is a triumph – and not a disaster, because age reflects improvement in socio-economic conditions, living standards, education and healthcare advances a country has made that enabled people to live longer,” he said. Citing a 2011 study on the prevalence of elderly mistreatment in Chennai involving 400 community-dwelling older adults aged 65 years, he said about 14% of them reported of mistreatment.
Advocacy campaigns and appropriate legislation could have a role in freeing India of age-related prejudices, negative attitudes, and age discrimination at individual, corporate and institutional level, he hoped.
Earlier, Mr M V Subbiah, Trustee, Vellayan Chettiar Trust, gave the presidential address, while Mr A Vellayan, Executive Chairman, Murugappa Group, and Trustee, Vellayan Chettiar Trust, introduced the Oration. Prof Krishnamoorthy Srinivas, Chairman Emeritus, The Institute of Neurological Sciences, Voluntary Health Services (TINS-VHS), welcomed the gathering and Dr ES Krishnamoorthy, Honorary Consultant, TINS-VHS, provided the concluding remarks.
About the MV Arunachalam Memorial Oration:
The MV Arunachalam Memorial Oration is held annually under the aegis of the MV Arunachalam Centre for Information and Education in the Neurosciences (MVA-CIEN) a dynamic part of The Institute of Neurological Sciences – VHS Hospital, Taramani, Chennai. Endowed by the Vellayan Chettiar Trust in 2001, MVA-CIEN provides counselling, information, education and advocacy to the 4000 patients from poor and lower middle class backgrounds who consult TINS – VHS every year. MVA-CIEN also runs free specialist counselling services for people with epilepsy and dementia. MVA-CIEN interacts with a number of Governmental organizations in providing care for people with disabling neurological and neuropsychiatric illnesses. The Late Mr. MV Arunachalam was known for the breadth of his vision and his philanthropy, and for his active contribution to various business and social causes.
About Dr Andrew Elder:
Andrew Elder is a Consultant Physician in Acute Medicine for Older People at the Western General Hospital in Edinburgh, Scotland, UK and an Honorary Senior Lecturer at the University of Edinburgh Medical School.
His clinical interest is in cardiovascular disease in older age, in particular heart failure, and he has authored chapters for several textbooks and contributed to SIGN clinical practice guidelines on this topic.
He has held a number of positions relating to undergraduate and postgraduate medical teaching and assessment at local and national levels, and is currently Chair of the Clinical Examining Board for the MRCP(UK) PACES examination – the largest international postgraduate clinical skills assessment in the world, with almost 5000 candidates sitting per year in eleven countries including India.
As Lead Hospital Adviser on Older Peoples Services to the Scottish Public Services Ombudsman since 2008 he has had a senior role in the governance and quality assurance of older peoples’ services in the NHS in Scotland, supporting the remediation of serious complaints about patient care and helping health care providers learn lessons from such complaints.
In 2010 -11 he was International Expert Adviser to the Hong Kong Health Authority, supporting the development of their first strategy for the care of older people.
About Murugappa Group
Founded in 1900, the Rs. 22314 Crores (USD 4.4 billion) Murugappa Group is one of India’s leading business conglomerates. The Group has 28 businesses including eight listed Companies actively traded in NSE & BSE. Headquartered in Chennai, the major Companies of the Group include Carborundum Universal Ltd., Cholamandalam Investment and Finance Company Ltd., Cholamandalam MS General Insurance Company Ltd., Coromandel International Ltd., Coromandel Engineering Company Ltd., E.I.D. Parry (India) Ltd., Parry Agro Industries Ltd., Tube Investments of India Ltd., and Wendt (India) Ltd.
Market leaders in served segments including Abrasives, Auto Components, Cycles, Sugar, Farm Inputs, Fertilizers, Plantations, Bio-products and Nutraceuticals, the Group has forged strong alliances with leading international companies like Groupe Chimique Tunisien, Foskor, Cargill, Mitsui Sumitomo, Morgan Crucible and Sociedad Química y Minera de Chile (SQM). The Group has a wide geographical presence spanning 13 states in India and 5 continents.
Renowned brands like BSA, Hercules, Ballmaster, Ajax, Parry’s, Chola, Gromor and Paramfos are from the Murugappa stable. The organization fosters an environment of professionalism and has a workforce of over 32,000 employees.