No Doctors for Old People

Sanghamitra Bhowmik, Dnaindia.com

April 27, 2008

India

India will have two million senior citizens by 2050. Will the much-needed geriatric healthcare systems be ready to take on this burden by then? They certainly aren’t right now, says Sanghamitra Bhowmik 

Tucked away in a corner of the hospital, every Friday the general medicine department at the state-run KEM Hospital doubles up as geriatric out patient department (OPD), between 1 and 3pm. 

Except that nobody — not even the hospital staff — knows about this. “There is no such department,” says the enquiry. The ward boys look puzzled when asked about this, and a resident doctor suggests that elderly patients be taken to the general OPD. 

A decade after the Ministry of Social Justice recommended that public health hospitals make special provisions for senior citizens — and the government set aside Rs400 crore under the National Programme for the Elderly in this Budget — nothing seems to have been done about this. 

Online searches and many phone calls later, it appears that Mumbai’s 11.8 lakh elderly have only one hospital they can turn to in the city: KEM. 

The National Policy for Older People (NPOP), that was formulated in 1999, recommended strengthening of primary healthcare systems for the elderly, geriatric training of medical personnel, promotion of healthy ageing and separate queues and reservation of beds for seniors. 

Today, except perhaps for separate queues, there is little else. Borivli resident Ajit Deshmukh, 65, and his wife Snehlata, 60, know that. When Deshmukh fractured his leg and had to be taken to a hospital, Snehalata, an arthritic patient herself, found it harrowing to complete the formalities. 

“We had to fill out a million forms and then go to various departments for tests, and then stand in queues for payments. It would have been nice if there was someone from the hospital to help,” says Deshmukh.

Unlike the US and UK, where just a senior citizen’s ID card can get her instant and competent medical attention, India’s 8.1crore elderly have to contend with practically no services. 

Yet geriatric medicine, which focuses on health promotion and prevention and treatment of diseases and disability in later life, is fast becoming a reality at hospitals. It certainly is at KEM Hospital, where older patients make up 30 per cent of its out patient list. The hospital launched its geriatric clinic 10 years ago, and purportedly has a geriatric assessment team including a social worker, occupational therapist, physiotherapist, dietician, psychiatrist and orthopaedic.
 
But few elderly patients know about this. “Most of our elderly patients are referred by social service organisations or other doctors. When they reach the registration counter, they are given a separate OPD paper and directed to us,” says Dr Raminder Singh, professor of medicine at KEM. 

Keeping a growing demand in mind, the Centre hopes to start two National Institutes of Ageing, eight regional centres and a department for geriatric medical care in one medical college/tertiary level hospital in each state. In Maharashtra, the government has sanctioned Rs16crore for a 100-bed geriatric hospital in Ambegaon, Beed district. “We plan to have 10-bed geriatric mental health clinics in every district which will have all the things required for geriatric care. We also plan to train doctors and nurses in this," says Vimal Mundada, state minister of health. Diagnosis and medication for the elderly can be tricky. 

Most senior citizens suffer from multiple ailments, and managing them can be a challenge. “The fact that the body and organs are ageing can make the situation complex. A geriatrician can be a boon in such situations, helping specialists and patients in managing treatment, diet and drug use,” says Mumbai-based cardiologist Sadanand Shetty.

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