3. • There's one advantage to being 102.
There's no peer pressure.
Dennis Wolfberg
• I truly believe that age –
if you're healthy -- age is just a number.
Hugh Hefner
• If I knew I was going to live this long, I'd
have taken better care of myself.
Mickey Mantle
4. And now the end is near And so I face
the final curtain, I’ll state my case of
which I’m certain. I’ve lived a life that’s
full, I traveled each and ev’ry highway,
And more, much more than this. I did
it my way.
5. 200 kms and
3 weeks long
walk at the
age of 61 is
not
impossible
for the fight
of freedom.
6. Was Not 92 when
he passed away
but 10 years old
with 82 years
of experience
7. Top of the world ??? No big deal !!!
We were just 73 and 76 years old when
we climbed it.
12. Scheme of Presentation
1. Introduction
2. 10 Facts on ageing (WHO)
3. The epidemiology of population ageing (WHO)
4. Situation analysis of ageing in India
5. Demography of ageing population in India
6. Studies on ageing in India
7. Fighting stereotypes
8. Challenges and opportunities
13. Introduction
• Ageing is a natural process that begins at
birth, or to be more precise, at conception, a
process that progresses throughout one’s life
and ends at death.
14. Who are the elderly or aged?
United Nations Organization
(UNO)
> 65 years of age as senior
citizens.
The Indian Census >60 years and above as
old.
15. Population 2012 Total >65 yrs
Global > 7 billion >56 million
India >1.2 billion 7 million
(United states population bureau)
India population > 60 > 10 million
Population proportion above 60 8%
(WHO)
16. 10 facts on ageing
1. The world population is rapidly ageing.
2. The number of people aged 80 and older will
quadruple in the period 2000 to 2050.
3. By 2050, 80% of older people will live in
low and middle-income countries.
Ref: WHO Fact File 2012
17. 10 facts on ageing
4. The main health burdens for older people are from
non-communicable diseases.
5. Older people in low- and middle-income countries
carry a greater disease burden than those in the rich
world.
6. The need for long-term care is rising.
7. Effective, community-level primary health care for
older people is crucial.
Ref: WHO Fact File 2012
18. 10 facts on ageing
8. Supportive, “age-friendly” environments allow
older people to live fuller lives and maximize the
contribution they make.
9. Healthy ageing starts with healthy behaviors in
earlier stages of life.
10. We need to reinvent our assumptions of old age.
Ref: WHO Fact File 2012
19. 1. Add Life to Years (1982)
2. Healthy Living: Everyone a winner (1986)
3. Active ageing makes the difference (1999)
4. Good Health adds life to years (2012)
WHO and Geriatric Health
20. The epidemiology of population
ageing
• Life expectancy
• Years lost due to premature death
• Years lost due to disability
• Disability adjusted life years
21. Life expectancy at birth
WHO Region Male ( Years) Female ( Years)
World 66 71
Africa 52 56
Americas 73 79
Eastern Mediterranean 64 67
Europe 71 79
South – East Asia 64 67
Western Pacific 72 77
Ref:World health statistics 2011. Geneva, WHO
22. Life expectancy at age 60
WHO Region Male ( 2009) Female ( 2009)
World 18 21
Africa 14 16
America 21 24
Eastern Mediterranean 16 18
Europe 19 23
South- East Asia 15 18
Western Pacific 19 22
Ref: World health statistics 2011. Geneva, WHO
23. Premature Death
Fig: Years of life lost
due to death per
100000 adults aged
60 yrs and
older by country
income group
Ref: World health statistics 2011. Geneva, WHO
Yearslostduetoprematuredeath
Diseases
24. Disability
Fig: Years Lost due
to Disability (YLDs)
per 100 000 adults
over age 60 by
country income
group
Yearslostduetodisability
Ref: World health statistics 2011. Geneva, WHO
Disability causes
25. Disability
High Income countries Low Income Countries
Visual Impairment 15.0 94.2
Hearing Loss 18.5 43.9
Osteoarthritis 8.1 19.4
Ischemic Heart Disease 2.2 11.9
Dementia 6.2 7.0
COPD 4.8 8.0
Cerebrovascular
Disease
2.2 4.9
Depression 0.5 4.8
Rheumatoid Arthritis 1.7 3.7
Ref: World health statistics 2011. Geneva, WHO
26. Total burden of Death and Disability
DALY
Fig: Disability
Adjusted Life years
( DALYs) per 100000
adults over age 60
by country income
group
Ref: World health statistics 2011. Geneva, WHO
Diseases
27. Other health problems
• Approximately 28-35% of people over the age
of 65 fall each year.
• Falls may lead to post-fall syndrome, which
includes increased dependence, loss of
autonomy, confusion, immobilization and
depression.
• Within the year following a hip fracture from a
fall, 20% of older people will die.
28. Other health problems
• Around 4-6% of elderly people have
experienced some form of maltreatment at
home.
• While depression is identified as a significant
cause of disability and a likely problem in
older age, social isolation and loneliness are
not recorded in these databases.
Ref: World health statistics 2011. Geneva, WHO
30. Situation analysis of elderly in India
• Majority population aged less than 30
• The problems and issues of its grey population has
not been given serious consideration
• Focus - on the children and the youth
• Rapid changes in the social scenario -nuclear
families
• Elderly - emotional, physical and financial insecurity
31. Situation analysis of elderly in India
• Ageing of population - downward trends in
fertility and mortality.
• Low birth rates coupled with long life
expectancies, push the population to an ageing
humanity.
• Mounting pressures on various socio economic
fronts including pension outlays, health care
expenditures, fiscal discipline, savings levels etc.
32. Demography of ageing population in
India
Ref: Situation analysis of the elderly in India, 2011
Fig: Age
distribution of
population in
India over
decades
33. Fig 3: More Older parents to
support
Fig 2: Dependency ratios, India
1961-2026
Fig 1: Population by broad age groups, India,
1961-2026
Ref: Situation analysis of the elderly in India, 2011
36. Studies on ageing in India
• Economic aspects of ageing
• Social aspects of ageing
• Psychological aspects of ageing
• Health conditions of elderly
• Malnutrition in elderly
• Mental Health in elderly
• Elder Abuse
• Crime in elderly
37. Economic aspects
• Are elderly a burden on the family and the
nation?
• 40 % of the elderly > 60 are working.
• While adults (in the age group 15-59) who are
not working and are dependants.
• Inadequate income is a major problem of the
elderly in India .
38. Economic aspects
• Nearly 90 per cent of total workforce
employed in the unorganized sector.
• Retire without any financial security
like pension and other post-
retirement benefits.
• Women depend more on others.
39. Social aspects
• Individualism in modern life
• Materialistic thinking among young
generation
• Greater alienation and isolation of the elderly
• Decline in value system, respect, honor, status
and authority for elderly
• Elderly relegated to an insignificant place in
our society
40. Social aspects
• The loss of the decision-making power by those
who have surrendered their property in favor of
younger members.
• The loss of status and decision-making power is
felt more by ageing women than men.
41. Social aspects
Provide support
Aid relationship
building
Maintenance,
facilitate coping
with stress
Issues in relation
to death and
dying.
Religiosity seems to have increase with age.
Spirituality was perceived to
42. Psychological aspects
The prominent thrust areas
resulting in socio-psychological
frustration among the elderly are
• Attitude towards old age
• Degradation of status in
community
• Problems of isolation
• Loneliness
• Generation gap
43. Psychological aspects
Shortage of money
Passing time
Widowhood
Feeling of physically weak
Fear of death
Mental tension
Feeling of social neglect
The problems of retirees mainly include:
44. Health conditions of elderly
• More and more susceptible to
chronic diseases, physical disabilities
and mental incapacities in their old
age.
• Illnesses are multiple and chronic in
nature.
• Arthritis, rheumatism, heart
problems and high blood pressure are
the most prevalent chronic diseases
affecting them.
45. How elderly describe their disease?
Elderly Poor Upper-class elderly
Describe their health problems,
on the basis of easily
identifiable symptoms, like
chest pain, shortness of breath,
prolonged cough,
breathlessness/ asthma, eye
problems etc.
In view of their greater
knowledge of illnesses, mention
blood pressure, heart attacks,
and diabetes which are largely
diagnosed through clinical
examination.
46. Malnutrition in elderly
• 50 % are at risk in low income group
• Both macro and micronutrient deficiencies are
common in elderly
• Malnutrition is due to
a. Lack of financial resources
b. Reduced ability to go to market
c. Reduced ability to cook nutritious meals
d. Difficulty in mastication
47. Mental health in elderly
The worries among the poor are usually about:
Inadequate
economic
support
Poor health
Inadequate
living space
Loss of respect
Unfinished
familial tasks
Lack of
recreational
facilities and
The problem
of spending
time
48. Multiplicity of disease
• Multiplicities of diseases are normal among
the elderly and that a majority of the old are
often ill with
Chronic bronchitis
Anemia
Hypertension
Digestive troubles
Rheumatism
49. Health, Literacy and Income
• Elderly members are confronted with various
nutritional, physiological and other general
problems.
• The men are more literate, economically
independent and face less physiological and
nutritional problems as compared to their
female counterparts.
50. Illness and treatment
• Most of the ailments of the elderly are not
medically treated.
• The two most important reasons for not
seeking care were
1.Financial problems
2.Perception that the ailment was not serious.
51. Elder abuse
A female
of very
advanced
age
Role-less
in family
Functionally
impaired
Lonely
The most likely victim of elderly abuse is a
52. Elder abuse
• The prevalent patterns of elder abuse include
1. Psychological abuse in terms of verbal assaults
2. Threats and fear of isolation
3. Physical violence
4. Financial exploitation
• More women than men complain of maltreatment
in terms of both physical and verbal abuse.
53. Elder abuse
• Person suffering from physical or mental
impairment and dependent on the caretakers for
most of his or her daily needs is likely to be the
victim of elder abuse.
• Old people with high educational background and
sufficient income are also found to be subjected
to abuse.
54. Elder abuse
• Who are the abuser?
• Factors for Abuse
Son and daughter in
law
Daughter in law and
spouse
Spouse
Dependent position of the older
Perceived powerlessness
Social isolation
Drug or alcoholic addiction
Anti-social behavior of the abusers
55. Crime against elderly
• These crimes range from hurt, robbery, murder
and even sexual assault.
• Most remain unreported.
• Female victims outnumber male victims
• More in urban areas as compared to rural
areas.
• 60 per committed indoors during the day.
• 25 percent by family members.
56. Elderly are heterogeneous group
• Rural elderly
• Urban Poor elderly
• Urban Middle Income and well to do elderly
• Female elderly
58. Urban poor elderly
Poor
Infrastructure
Poor physical
condition
Low income levels
High rates of
unemployment
/underemployment
Crime, alcoholism,
mental illness
Lack of public and
community
facilities
Lack of access to
affordable healthcare
services.
59. Urban middle income and well-to-do
elderly
• The impact of urbanization has touched many
a life leading to migration of children to cities
or abroad.
• Many elderly are well-off due to their
prosperous children but are left alone to take
care of themselves.
60. Female elderly
• Feminization of later life.
The female elderly are more likely to be
Widowed
Have low
economic
security
Lower
educational
attainment
More care
giving
responsibilities
than their male
counterparts.
61. Female elderly
• The absence of gender-specific health services
• Poor health due to child bearing
• Less nutrition
• Economic deprivation throughout their lives
62. Female elderly
• The loss of status at the death of their
husband only increases the situation of
dependency in old age.
• This dependency can become more complex
as the woman grows older
• Her relationship with her son and daughter-in-
law decides her fate in old age
64. Common stereotyping of elderly
1. Older people are "past their sell-by date“
2. Older people are helpless .
3. Old people are afraid of dying.
4. Older people will eventually become senile .
5. Older women have less value than younger
women .
6. Older people don't deserve health care
65. 1.Older people are
"past their sell-by
date"
• On 16 October 2011,
Fauja Singh became the
first 100 year-old to
complete a marathon by
running the Toronto
Waterfront Marathon in
Canada.
66. 2.Older people are helpless
• 2007 Cyclone in Bangladesh
• Older people’s committees
disseminated early warning
messages to people and
families most at risk
• Identified who were worst hit
• Compiled beneficiary lists and
notified them when and where
to receive relief goods
67. 3.Old people are afraid of dying
• 2011 earthquake and Tsunami in Japan
• Older people and retirees came forward to
volunteer at the nuclear disaster sites
68. 4.Older people will eventually
become senile
• Occasional memory lapses occur at any age
• Some types of our memory stay the same or
even continue to improve with age
• Our semantic memory, which is the ability to
recall concepts and general facts that are not
related to specific experiences
69. 5.Older women have less value than
younger women
• People often equate women’s worth with
beauty, youth and the ability to have children.
• The role older women play in their families
and communities, caring for their partners,
parents, children and grandchildren is often
overlooked.
• Women tend to be the family caregivers.
• Many take care of more than one generation.
70. 6.Older people don't deserve health
care
• Treatable conditions -often overlooked or
dismissed as being a "normal part of ageing".
• Age does not necessarily cause pain, and only
extreme old age is associated with limitation of
bodily function.
• The right to the best possible health does not
diminish as we age.
71. • It is not age that limits the health and participation of
older people.
• It is individual and societal misconceptions,
discrimination and abuse that prevent active and
dignified ageing.
6.Older people don't deserve health
care
72. Challenges and opportunities
• Elderly people are a heterogeneous group.
• It is essential to recognize this heterogeneity in
defining need, assessing the effects and relevance
of intervention, and planning for the future.
• Ageing population will change society at many
levels and in complex ways, creating both
challenges and opportunities.
73. Opportunities of ageing
• Older people already make a significant
contribution to society, whether it is through
the formal workforce, through informal work
and volunteering or within the family.
• We can foster this contribution by helping
them maintain good health and by breaking
down the many barriers that prevent their
ongoing participation in society.
74. Challenges of ageing
• Towards the end of life, many older people
will face health problems and challenges to
their ability to remain independent.
• We need to address these too, and do it in a
way that is affordable and sustainable for
families and society.
75. • Good health must lie at the core of any successful
response to ageing.
• If we can ensure that people are living healthier as
well as longer lives, the opportunities will be greater
and the costs to society less.
Challenges of ageing
76. • Recognize them as a resource group
• Develop suitable policies
78. National Policies & Programmes for the
Welfare of the Elderly: Introduction
1. Majority (80%) of them are in the
rural areas, thus making service
delivery a challenge
2. Feminization of the elderly
population ( 51% of the elderly
population would be women by the
year 2016),
3. Increase in the number of the
older-old ( persons above 80years)
and
4. A large percentage (30%) of the
elderly are below poverty line.
79. National Policies & Programmes for the
Welfare of the Elderly
1. Administrative set-up
2. Relevant Constitutional Provisions
3. Legislations
4. National Policy on Older Persons (NPOP), 1999
5. National Council for Older Persons
6. Inter-Ministerial Committee on Older Persons
80. National Policies & Programmes for the
Welfare of the Elderly
7. Central Sector Scheme of Integrated Programme for Older
Persons (IPOP)
8. Schemes of Other Ministries
I. Ministry of Health & Family Welfare
– National Programme For Health Care Of The Elderly (NPHCE)
II. Ministry of Rural Development
III. Ministry of Railways
IV. Ministry of Civil Aviation
V. Ministry of Finance
VI. Department of Pensions and Pensioner Grievances
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
81. 1.Administrative set-up
Ministry of Social Justice
& Empowerment
Nodal Ministry which focuses on policies &
programmes for the Senior Citizens in close
collaboration with State governments, NGOs and
Civil society.
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
82. 2.Relevant Constitutional Provisions
Article 41 of the Constitution provides that
the State shall, within the limits of its economic
capacity and development, make effective
provision for securing the right to work,
to education and to public assistance in cases of
unemployment, old age, sickness & disablement,
& in other cases of undeserved want.
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
83. 3.Legislations
Maintenance and Welfare of Parents and Senior
Citizens Act, 2007:
To ensure need based maintenance for parents and senior
citizens and their welfare.
The Act provides for:-
Maintenance of Parents/ senior citizens by children/ relatives
made obligatory and justiciable through Tribunals
Revocation of transfer of property by senior citizens in case of
negligence by relatives
Penal provision for abandonment of senior citizens
Establishment of Old Age Homes for Indigent Senior Citizens
Adequate medical facilities and security for Senior Citizens
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
84. 3.Legislations
Maintenance and Welfare of Parents and Senior
Citizens Act, 2007:
– The Act has to be brought into force by individual State
Government.
– As on 3.2.2010, the Act had been notified by 22 States and
all UTs.
– The Act is not applicable to the State of Jammu & Kashmir
– The remaining States yet to notify the Act are - Bihar,
Meghalaya, Sikkim and Uttar Pradesh.
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
85. 4.National Policy on Older Persons
(NPOP), 1999
Ref: National Policy on Older Persons (NPOP), 1999 Ministry of Social Justice & Empowerment, GOI
86. 4.National Policy on Older Persons
(NPOP), 1999
Announced in January 1999 to reaffirm the commitment to
ensure the well-being of the older persons.
Envisages State support to ensure
– financial and food security,
– health care,
– shelter,
– equitable share in development,
– protection against abuse and exploitation,
– availability of services to improve the quality of their lives
Ref: National Policy on Older Persons (NPOP), 1999 Ministry of Social Justice & Empowerment, GOI
87. 4.National Policy on Older Persons
(NPOP), 1999
Objectives:
To encourage individuals to make provision for their own as
well as their spouse’s old age;
To encourage families to take care of their older family
members;
To enable and support voluntary and non-governmental
organizations to supplement the care provided by the family;
To provide care and protection to the vulnerable elderly
people;
Ref: National Policy on Older Persons (NPOP), 1999 Ministry of Social Justice & Empowerment, GOI
88. 4.National Policy on Older Persons
(NPOP), 1999
Objectives:
To provide adequate healthcare facility to the elderly;
To promote research and training facilities to train geriatric
care givers and organizers of services for the elderly;
To create awareness regarding elderly persons to help them
lead productive and independent live.
Ref: National Policy on Older Persons (NPOP), 1999 Ministry of Social Justice & Empowerment, GOI
89. 4.National Policy on Older Persons
(NPOP), 1999
Implementation Strategy :
Preparation of Plan of Action for operationalisation of the
National policy.
Setting up of separate Bureau for Older Persons in Ministry of
Social Justice & Empowerment.
Three Yearly Public Review of implementation of policy.
Ref: National Policy on Older Persons (NPOP), 1999 Ministry of Social Justice & Empowerment, GOI
90. 4.National Policy on Older Persons
(NPOP), 1999
Implementation Strategy:
Setting up of a National Council for Older Persons
Establishment of Autonomous National Association of Older
Persons
Encouraging the participation of local self-government
Ref: National Policy on Older Persons (NPOP), 1999 Ministry of Social Justice & Empowerment, GOI
91. 5. National Council for Older
Persons(NCOP)
Constituted in 1999
Under the Chairpersonship of the Minister for Social Justice &
Empowerment to oversee implementation of the Policy
Highest body to advise the Government in the formulation and
implementation of policy and programmes for the aged
Last re-constituted in 2005 with members comprising Central and State
governments representatives, representatives of NGOs, citizen’s groups,
retired person’s associations, and experts in the field of law, social welfare,
and medicine
With a view to have a more definite structure, the Council was
reconstituted and renamed as National Council for Senior Citizens (NCSrC)
vide a Resolution dated 17.02.2012 to this effect which was published in
the Gazette of India on 22.02.2012.
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
92. 6.Inter-Ministerial Committee on
Older Persons
Comprises of twenty-two Ministries/Departments,
Headed by the Secretary, Ministry of Social Justice &
Empowerment
Another coordination mechanism in implementation of the
NPOP.
Considers Action Plan on ageing issues for implementation by
various Ministries/ Departments concerned, from time to
time
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
93. 7.Central Sector Scheme of Integrated
Programme for Older Persons(IPOP)
Implemented since 1992
Objective of improving the quality of life of senior citizens by
providing basic amenities like
– shelter,
– food,
– medical care and
– entertainment opportunities
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
94. 7.Central Sector Scheme of Integrated
Programme for Older Persons(IPOP)
Encouraging productive and active ageing through providing
support for capacity building of Government/ Non-
Governmental Organizations/Panchayati Raj Institutions/ local
bodies and the Community at large.
Under the Scheme, financial assistance up to 90% of the
project cost is provided to nongovernmental organizations for
establishing and maintaining old age homes, day care centres
and mobile medicare units
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
95. 7.Central Sector Scheme of Integrated
Programme for Older Persons(IPOP)
Other projects for Financial Assistance under revised
scheme from 2008:
– Maintenance of Respite Care Homes;
– Running of Day Care Centres for Alzheimer’s Disease Patients,
– Physiotherapy Clinics for older persons;
– Sensitizing programmes for children particularly in Schools &
Colleges;
– Training Centres of Caregivers to the older persons;
– Awareness Generation Programmes for Older Persons & Care
Givers;
– Formation of Senior Citizens Associations etc
Ref: Situation Analysis Of The Elderly in India, June 2011, Ministry of Statistics & Programme Implementation, GOI
96. 8.Schemes of Other Ministries
I. Ministry of Health & Family Welfare
– Separate queues for older persons in government
hospitals.
– Started Geriatric clinic in several Govt. hospitals
– National Programme For Health Care Of The Elderly
(NPHCE)
Ref: Ministry of Health & Family Welfare, GOI
97. 8.Schemes of Other Ministries
II. Ministry of Rural Development
– Implementing Indira Gandhi National Old-age
Pension Scheme.
– For persons above 60 years belonging to a household
below poverty line,
– Central assistance @ Rs. 200/- per month, which is meant
to be supplemented by at least an equal contribution by
the States so that each beneficiary gets at least Rs.400/-
per month as pension.
Ref: Ministry of Rural Development, GOI
98. 8.Schemes of Other Ministries
III. Ministry of Railways
– Separate ticket counters for senior citizens of age 60 years
and above at various (Passenger Reservation System) PRS
centres
– Provision of lower berth to male passengers of 60 years
and above and female passengers of 45 years and above.
– 40% and 50% concession in rail fare for male passengers
aged 60years and above and female passengers aged 58
years and above respectively.
– Wheel chairs at stations for old age passengers.
Ref: Ministry of Railways, GOI
99. 8.Schemes of Other Ministries
IV. Ministry of Civil Aviation
– Air India provides concession up to 50% for male senior
citizens of 65 years and above, and female senior citizens
of 63 years and above in air fares.
Ref: Ministry of Civil Aviation, GOI
100. 8.Schemes of Other Ministries
V. Ministry of Finance
– Income tax exemption for senior citizen of 65 years and
above up to Rs. 2.50 lakh per annum.
– Deduction of Rs 20,000 under Section 80D is allowed to an
individual who pays medical insurance premium for his/
her parent or parents, who is a senior citizens of 65 years
and above.
– An individual is eligible for a deduction of the amount
spent or Rs 60,000, whichever is less for medical treatment
(specified diseases in Rule 11DD of the Income Tax Rules)
of a dependent senior citizen of 65 years and above
Ref: Union Budget 2012-13, Ministry of Finance, GOI
101. 8.Schemes of Other Ministries
VI. Department of Pensions and Pensioner Grievances
• A Pension Portal has been set up to enable senior citizens to
get information regarding the status of their application, the
amount of pension, documents required, if any, etc.
• The Portal also provides for lodging of grievances.
As per recommendation of the Sixth Pay Commission,
additional pension to be provided to older persons
Age Group % pension to be added
80+ 20
85+ 30
90+ 40
95+ 50
100+ 100
104. The Vision
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
To provide accessible, affordable, and high-quality long-
term, comprehensive and dedicated care services to an
Ageing population;
Creating a new “architecture” for Ageing;
To build a framework to create an enabling environment for
“a Society for all Ages”;
To promote the concept of Active and Healthy Ageing;
105. Objectives
• Provision of dedicated health care facilities at various level
of State health care delivery system with referral support
• Human resource development in geriatric Health
• Strengthening of preventive, promotive and rehabilitative
services.
• Promotion of Research in geriatric health care
• Convergence with NRHM, AYUSH & all other dept.
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
106. Strategies
Core
Strategies
Community
level -
domiciliary
visits by trained
health care
workers.
PHC/CHC level -
equipment,
training,
additional human
resources (CHC),
IEC,
District Hospital -
10 bedded wards,
additional human
resources,
8 RMC - PG
courses in
Geriatric
Medicine, and
training
IEC using mass
media, folk media
and other
communication
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
107. Supplementary Strategies
Promotion of
public private
partnerships in
Geriatric Health
Care.
Mainstreaming AYUSH
and convergence with
programmes of
Ministry of Social
Justice and
Empowerment in the
field of geriatrics.
Reorienting
medical education
to support
geriatric issues.
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
108. Major Components:
1. Geriatric Department in 8 Regional Medical Institutions/
State Medical Colleges
2. Dedicated Health Care in 100 Districts(21 states)
Geriatric unit at District hospitals
Rehabilitation Units at CHCs
Weekly Geriatric Clinic at PHCs
Provision of supportive devices/equipments at Sub
centers
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
109. Operational Guidelines
A. Package of
Services at
different levels
B. Institutional
framework for
implementation
C. Management
Structure
D. Activities at
various levels
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
110. A. Package of Services
Health
promotion
Preventive
service
Diagnosis &
management
Day care
services
Rehabilitative
services
Home based
care
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
111. A. Package of Services
Organizational Structure:
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
112. B. Institutional Framework for the
Implementation of NPHCE
Funds from Government of
India (80%)
State Health Society
District Health Society
(NCD Cell)
CHC / PHC /SC
State Level Activity
District Level Activity
Funding for Program:
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
113. B. Institutional Framework for the
Implementation of NPHCE
State Health Society (SHS):
Under the NRHM framework different Societies of national
programmes such as RCH, Malaria, TB, Leprosy, NBCP have
been merged into a common State Health Society.
– Chairperson- Chief Secretary/Development commissioner
– Vice chair person -Principal Secretary (H&FW)
– Mission director - Member –Secretary of SHS
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
114. B. Institutional Framework for the
Implementation of NPHCE
District Health Society (DHS):
All programme societies have been merged into the District
Health Society (DHS).
The Governing Body
– Chairperson - Chairman of the Zilla Parishad.
– Member -Secretary - DHO
The Executive Body
– Chair person - District Collector
– Member -Secretary - DHO.
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
115. C. Management Structure
National NCD Cell
State NCD Cell
District NCD Cell
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
116. C. Management Structure
National NCD Cell:
The NCD Cell constituted at the central level for planning,
monitoring and implementation of the National Programme
for Prevention and Control of Cancer, Diabetes, CVD and
Stroke (NPCDCS) will also be responsible for NPHCE.
Main functions:
MOU with the States/UTs.
Preparation and dissemination of operational guidelines.
Plan for capacity building of health functionaries.
Monitoring and review of programme activities at each level.
Release of funds and monitoring of expenditure under NPHCE
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
117. C. Management Structure
20% of the
total
expenditure
Provision of
land
Support of lab
services
Additional
support for
medicines
Maintenance
of equipments,
wards and OPD
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
State contribution:
118. C. Management Structure
State Programme Officer
Programme Assistant
Finance cum Logistics Officer
Data Entry Operators (2)
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
State NCD Cell:
Composition:
State NCD Cell will be supported by following contractual staff:
119. C. Management Structure
State NCD Cell:
Role and responsibilities of the State NCD Cell:
Preparation of State action plan for implementation.
Organize State & district level trainings
for capacity building
Liaison with Regional Geriatric Centre for
tertiary Care, Training & Research.
Monitoring of the programme
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
120. C. Management Structure
District Programme Officer
Programme Assistant
Finance cum Logistics Officer
Data Entry Operators
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
District NCD Cell:
Composition:
District NCD Cell will be supported by following contractual staff:
121. C. Management Structure
District NCD Cell:
Role and responsibilities of the District NCD Cell:
Preparation of District action plan.
Engage contractual personnel sanctioned for various facilities
in the district
Maintain fund flow
Convergence with NRHM activities & Other Depts.
Ensure availability of rehabilitative services for the Elderly.
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
122. D.Activities under NPHCE at Various levels
At Sub Centre level:
Provision of walking sticks, calipers & other supportive
equipments to the needy elderly
Information on healthy diet, yoga, and life style diseases
through charts, pamphlets
Domiciliary visit to the house of elderly by ANM/ Male worker
and maintenance of record
Arrangement of ambulance for disabled bed ridden elderly for
referral to PHC/CHC.
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
123. D.Activities under NPHCE at Various levels
At PHC level:
The weekly geriatric clinic.
Coordination with CHC, district hospital, sub centers, other National
Health Programmes/ Departments for medicines, ambulances
Training of manpower & Separate registration counter for elderly.
Public awareness during health and village sanitation day/camps.
Provision of medicine to the elderly for their medical ailments.
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
124. D.Activities under NPHCE at Various levels
At PHC level:
Following items will be made available at the PHC:
• Nebulizer
• Glucometer
• Shoulder Wheel
• Walker (ordinary)
• Cervical traction (manual)
• Exercise Bicycle
• Lumbar Traction
• Gait Training Apparatus
• Infrared Lamp etc.
.
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
125. D.Activities under NPHCE at Various levels
At RH/CHC level:
First level referral centre for medical care and rehabilitation
services
Twice weekly health clinics for the elderly persons
Rehabilitation unit
Domiciliary visits for disabled persons by Multi rehabilitation
worker
Referral Services to DH /RGC
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
126. D.Activities under NPHCE at Various levels
At RH/CHC level:
Following additional items will be made available at the CHC:
• ECG Machine
• Pulse Oximeter
• Defibrillator
• Multi - Channel Monitor
• Shortwave Diathermy
• Cervical traction (intermittent)
• Walking for gait training equipment
• Walking Sticks
• Pulley
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
127. D.Activities under NPHCE at Various levels
At District Hospital level:
Regular Geriatric OPD with Specialty Care for Elderly.
Geriatric Ward (10-bedded) for in-patient care to the Elderly.
Training to the Medical officers and paramedical staff of
CHC’s and PHC’s
Camps for Geriatric Services in PHCs/CHCs and other sites
Referral services for severe cases to tertiary level hospitals/
Regional Geriatric Centers
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
128. D.Activities under NPHCE at Various levels
At District Hospital level:
Following additional items will be made available at the District
Hospital:
• Multi-channel Monitor
• Non invasive Ventilator
• Ultrasound Therapy
• Pelvic traction (intermittent)
• Trans electric Nerve stimulator (TENS)
• Adjustable Walker.
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
129. D.Activities under NPHCE at Various levels
At Regional Geriatric Centers level:
Provide tertiary level services for complicated/serious
Geriatric Cases.
Post graduate courses in Geriatric Medicine.
Training to the trainers of identified District hospitals and
Medical Colleges.
Specialized OPDs in all the specialties available with them for
the benefit of the Elderly30 bedded geriatrics ward
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
130. D.Activities under NPHCE at Various levels
At Regional Geriatric Centers level:
Following additional items will be made available at the
RGC:
• Interferential therapy for pain
• Continuous passive Motion units for Shoulder
• Knee Modular monitor
• Aero beds, Non-invasive ventilator
• Invasive ventilator
• Emergency trolleys (with multichannel monitors)
• Portable X-ray unit, Portable ultrasound
• Provision of Video conferencing unit
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
131. Regional Geriatrics Centers
Sr
No Regional Institutes States Linked
1 All India Institute of Medical Sciences,
New Delhi
Delhi, Haryana, Uttarakhand,
Punjab Himachal Pradesh, M.P.
2 Institute of Medical Sciences, Banaras
Hindu University, Uttar Pradesh
Uttar Pradesh, Bihar, Jharkhand,
West Bengal
3 Grant Medical College & JJ Hospital,
Mumbai, Maharashtra,
Maharashtra, Goa, Northern
Districts of Karnataka,Chattisgarh
4 Sher-e-Kashmir Institute of Medical
Sciences, Srinagar, Jammu & Kashmir
Jammu & Kashmir
5 Govt. Medical College,
Tiruvananthapuram, Kerala,
Kerala, Southern Districts of
Karnataka & Tamil Nadu
6 Guwahati Medical College, Guwahati,
Assam
Assam & NE States
7 Madras Medical College, Chennai, TN. Tamil Nadu, Andhra Pradesh, Orissa
8 SN Medical College, Jodhpur, Rajasthan Rajasthan & Gujarat
132. Developing Geriatric Department in Medical college
of each States/UTs
It is proposed to develop 12 additional Regional Geriatric
Centers in selected Medical Colleges of the country
132
Sr No State Medical College
1 Punjab PGIMER, Chandigarh
2 Uttar Pradesh KGIMS, Lucknow
3 Jharkhand Ranchi Medical College, Ranchi
4 West Bengal Kolkatta Medical College, Kolkata
5 Andhra Pradesh Nizam Institute of Medical Sciences, Hyd.
6 Karnataka Bangalore Medical College, Bangluru
7 Gujarat B.J.Medical College, Ahmadabad
8 Maharashtra Government Medical College, Nagpur
9 Orissa S.C.B.Medical College, Cuttack
10 Tripura Agartala Medical College, Agartala
11 Madhya Pradesh Gandhi Medical College, Bhopal
12 Bihar Patna Medical College, Patna
133. Phasing of physical targets
Physical target 2010-2011 2011-2012
Establishment of
Geriatric Department
at 8 Regional Inst.
8 Regional Inst.
Construction &
Manpower deployment
etc.
Fully functional
Geriatric Dept in 8
Regional Inst.
Setting up of
Geriatrics Unit at 100
District Hospitals
30 Districts
Construction and
equipment &
Manpower
deployment etc
30 Districts
Fully functional
Geriatric Unit
70 Districts
Construction and
equipment
-Manpower
deployment
134. Identified States and 30 districts (2010-11)
States Districts
Andhra Pr. Nellore, Vijayanagram
Assam Dibrugarh, Jorhat
Bihar Vaishali, Rohtas
CH Bilaspur
Gujarat Gandhi Nagar, Surendranagar
Haryana Mewat
HP Chamba
J&K Leh, Udhampur
Jharkhand Bokaro
Karnataka Shimoga, Kolar
Kerala Pathanathitta
States Districts
Madhya Pr. Ratlam
Maharashtra Washim, Wardha
Sikkim East Sikkim
Orissa Naupada
Punjab Bhatinda
Rajasthan Bhilwara, Jaisalmer
Uttrakhand Nainital
Tamil Nadu Theni
Uttar Pr. Rae Bareli, Sultanpur
West Bengal Darjeeling
135. 70 districts added in 2011-12
States Districts
Andhra Pr.
Srikakulam, Chittoor, Cuddapah,
Krishna, Kurnool, Prakasham
Assam Lakhimpur, Sibsagar, Kamrup
Bihar
Muzaffarpur, Paschim Champaran,
Poorva Champaran, Keimur
CH Jashpur Nagar, Raipur
Gujarat
Rajkot, Jam Nagar, Porbandar,
Junagarh
Haryana
Yamuna Nagar, Kurukshetra ,
Ambala
HP Lahaul & Spiti , Kinnaur
J&K Kupwara, Doda (Erstwhile), Kargil
Jharkhand Ranchi, Dhanbad
Karnataka Udupi, Tumkur, Chikmagalur
Kerala
Kozikode (Calicut), Allappuzha,
Idukki , Thrishur
States Districts
Madhya Pr.
Hoshangabad, Chindwara,
Jhabua , Dhar
Maharashtra
Gadchiroli, Bhandara,
Chandrapur, Amaravati
Sikkim South Sikkim
Orissa
Balangir, Nabrangpur,
Koraput, Malkangiri
Punjab Gurdaspur, Hoshiarpur
Rajasthan
Jodhpur, Ganga Nagar,
Bikaner, Barmer, Nagaur
Uttrakhand Almora
Tamil Nadu
Coimbatore, Virudhnagar,
Toothukudi, Tirunelveli
Uttar Pr.
Jhansi, Lakhimpur Kheri,
Farookhabad, Firozabad,
Etawah, Lalitpur,
Jalaun
West Bengal Jalpaiguri, Dakshin Dinajpur
136. Proposed Monitoring Strategy
Integrated monitoring by NCD Cells at centre , States, districts
and CHCs.
Monthly Progress Report to be submitted by NCD cells.
Half yearly progress review meeting for assessing the status of
implementation of the programme activities.
Yearly Combined field visit by Central and State Cells for on the
spot assessment of progress of the activities.
Ref: National Programme For Health Care Of The Elderly (NPHCE),Operational Guidelines, MOHFW, GOI
137. Achievements
Developed operational guidelines
1st installment released to 27districts in 2010-11 and
48 districts in 2011-12
1st installment released to all the 8 RMI
MOU signed with – 18 States
Submitted 12th plan proposal- all the States/districts
proposed to be covered
Ref: Two years (2009-2011) Achievements and New Initiatives. , Ministry of Health and Family Welfare, GOI
138. Achievements
Release of Funds:
Year
No. of
districts
Amount
released
(crore)
No. of
RMI
Amount
released
(crore)
2010-11 27 60 4 41.15
2011-12 48 75 4 30.31
Total 75 135 8 71.46
139. Issues for consideration
Create awareness among
policy makers & programme
officers
Training of manpower
Utilization of released Budget
Monitoring & Maintenance of
database
141. NGOs for Older Persons in India
HelpAge India
Agewell Foundation
Maitri
GiveIndia
India Sponser
142. HelpAge India
- 33 offices across India.
Mission:
HelpAge India's mission is to work for the cause and care of
disadvantaged Older Persons, in order to improve the quality
of their lives.
Objectives :
• To foster the welfare of the aged in India especially the needy
aged
• To raise funds for projects which assist the elderly irrespective
of cast or creed
• To create in the younger generation and in society an
awareness about the problems of the elderly in India today
143. HelpAge India
Activities:
• Focuses on
– improved access to health and
– eye care facilities,
– community-based services, and
– livelihood support for the elderly.
– Support-A-Grandparent scheme.
• Acts as the voice of the elderly and promotes their cause with
the central and state governments.
• Endeavors to influence decision-makers to formulate policy
that is beneficial to the elderly.
144. NGOS for Older Persons in Pune
• Adhar Sevavrat Old Age
Home
• Apala Ghar Old Age Home
• Apulaki Vriddhashram
• Arpan Old Age Home
• Goldage Ashram & Hospital
• Janseva Foundation
Destitute Rehabilitation
Centre
• Jiwhala Vriddhashram
• Matoshri Vriddhashram
• Niwara
• Olava Senior Citizens Home
• Pitashri-old Age Home
• Sahjeevan Ashram
• Sankalp Sevadham
• Savali
• Tapodham
• Umed Care Centre For Old
Age
• Vanaprastha Ashram
145. NIWARA
Niwara means ‘loving home’
Founded on 9th of August 1863, by visionaries
& eminent citizens of Pune
• ‘Niwara’ – David Sasoon Anath Pangu Gruha
Charitable Trust devoted wholly &
entirely to the welfare of old men & women, who
– do not have near relatives like spouse, son/daughter,
– have no home to live in &
– have no source of livelihood.
ie. offers home to the real destitutes in the society
Take care of inmates till the end of journey; the Vaikuntha
crematorium ironically enough, just beyond the boundary
walls!
146. NIWARA
Objectives of the trust :
1) To provide shelter, conducive food, clothes, bed, medicines &
other facilities to elderly men & women
2) To extend co-operation to like minded institutions in pune or
outside
3) To arrange entertainment programs for the inmates and to
arrange for their orientation and training so that their inherent
capacities and qualities are fastened and enhanced.
4) To make efforts for rehabilitating the inmates among their
relatives if possible
5) To undertake training and consultative programs for the elderly.
6) To arrange and monitor studies and research regarding the issues
of the old men and women.
147. NIWARA
Current No. of Inmates: 43 male & 84 female
Facilities:
Rehabilitation centre
Physiotherapy
Homeopathy clinic
Gymnasium
Meeting Hall
Activities:
Festivals
Trips & Excursions
Entertainment
148. REFERENCES
• National Program for Health Care of the Elderly (NPHCE) :
Towards active and healthy ageing. Operational Guidelines.
Director General of Health Services, MOHFW, Government of
India.
• Situation Analysis of The Elderly In India, June 2011. Central
Statistics Office, Ministry of Statistics & Programme
Implementation, Government of India
• Rajan SI. Population ageing and health in India. The Centre for
Enquiry into Health and Allied Themes (CEHAT), Mumbai. July
2006.
• National Policy on Older Persons (1999). Ministry of Social
Justice and Empowerment, Government of India, Shastri
Bhawan, New Delhi.
• Maintenance and Welfare of Parents and Senior Citizens Act –
2007, Ministry of Social Justice and empowerment Government
of India
• Morbidity, Health care and the Condition of the aged. NSSO (64th
round)Jan-June 2004, National Sample Survey Organization,
Ministry of Statistics and Programme Implementation,
Government of India, March 2006.
149. • Two years (2009-2011) Achievements and New
Initiatives. NRHM, Ministry of Health and Family
Welfare, Government of India.
• Ingle GK, Nath A. Geriatric Health in India: Concerns and
Solutions. Indian J Comm Med, 2008; 33 (4); 214-18.
• Prevention & Control of Non-Communicable Diseases
(NCDs): Proposal for the 12th Plan, Report of the
Working Group on Disease Burden: Non-Communicable
Disease (NCDs), Director General of Health Services,
MOHFW, Government of India.
• Planning Commission. 11th five year plan (Draft),
Government of India;
http://www.planningcommission.nic.in
Article 41 of the Constitution provides that the State shall, within the limits of its economic capacity and development, make effective provision for securing the right to work, to education and to public assistance in cases of unemployment, old age, sickness & disablement, & in other cases of undeserved want.
Further, Article 47 provides that the State shall regard the raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties….
This Act includes the following aspects:-
a) Senior Citizens can claim maintenance from children/grand children.
b) Tribunal shall decide such claims expeditiously.
c) Property of Senior Citizens shall be protected from forcible transfer.
d) A Geriatric Ward shall be provided in every District Level Hospital.
e) An Age Old Home shall be available in each District.
f) Abandoning a Senior Citizen shall be punishable with imprisonment of 3 months or fine up to Rs 5000 or both.
Maintenance and Welfare of Parents and Senior Citizens Act, 2007:
The Act has to be brought into force by individual State Government.
As on 3.2.2010, the Act had been notified by 22 States and all UTs.
The Act is not applicable to the State of Jammu & Kashmir, while Himachal Pradesh has its own Act for Senior Citizens.
The remaining States yet to notify the Act are - Bihar, Meghalaya, Sikkim and Uttar Pradesh.
Implementation Strategy adopted for operationalisation of National Policy envisages the following:
Implementation Strategy :
Preparation of Plan of Action for operationalisation of the National policy.
Setting up of separate Bureau for Older Persons in Ministry of Social Justice & Empowerment.
Setting up of Directorates of Older Persons in the States.
Three Yearly Public Review of implementation of policy.
Setting up of a National Council for Older Persons headed by Ministry of Social Justice & Empowerment from Central Ministry, states, Non-Official members representing NGOs, Academic bodies, Media and experts as members
Establishment of Autonomous National Association of Older Persons
Encouraging the participation of local self-government
I. Ministry of Health & Family Welfare
Separate queues for older persons in government hospitals.
Two National Institute on Ageing at Delhi and Chennai have been set up
Geriatric Departments in 25 medical colleges have been set up.
National Programme For Health Care Of The Elderly (NPHCE)
II. Ministry of Rural Development
Implemented the National Old-age Pension Scheme (NOAPS)
For persons above 65 years belonging to a household below poverty line,
Central assistance is given towards pension @ Rs. 200/- per month, which is meant to be supplemented by at least an equal contribution by the States so that each beneficiary gets at least Rs.400/- per month as pension.
The Ministry has lowered the age limit from the existing 65 years to
60 years and the pension amount for senior citizens of 80 years and above
has also been enhanced from Rs. 200/- to Rs. 500/- per month with effect
from 1.4.2011. It is estimated that there are about 72.29 lakh additional
persons living below the poverty line, who would become eligible to receive
central assistance under IGNOAPS in the age group of 60-64 years and
there are 26.33 lakh persons above the age of 80 years living below thepoverty line, who would become eligible to receive enhanced central
assistance @ 500 per month. The number of beneficiaries is expected to
increase from 171 lakh to 243 lakh. The decision of the Government of India
regarding lowering the age limit from 65 to 60 years along with the revised
guidelines have been issued to all States/ UTs vide letter no.J-
11015/1/2011-NSAP dated 30th June 2011.
The Programme has been formulated in pursuance to:
National Policy on Older Persons (1999)
The Maintenance and Welfare of Parents and Senior Citizens Act, 2007.
Objectives :
To provide an easy access to promotional, preventive, curative and rehabilitative services to the elderly through community based primary health care approach
To identify health problems in the elderly and provide appropriate health interventions in the community with a strong referral backup support.
To build capacity of the medical and paramedical professionals as well as the care-takers within the family for providing health care to the elderly.
To provide referral services to the elderly patients through district hospitals, regional medical institutions
Convergence with National Rural Health Mission, AYUSH and other line departments like Ministry of Social Justice and Empowerment.
PPP:- (Source :- The Technopak report on Age-Sensitive Hospitals June 2012 ) http://pharmabiz.com/NewsDetails.aspx?aid=69430&sid=1
In the corporate sector, Apollo Hospital, Chennai has a department of Geriatric Medicine. Hyderabad-based Heritage Hospitals also have a separate geriatric department. Many hospitals in the metro cities including Max, Fortis, Rockland, Pushpanjali, Crosslay and Jaipur Golden in Delhi have started programmes targeting geriatric care. Small standalone geriatric hospitals such as Vindhya Geriatric hospital in Bangalore and Aastha Hospital in Lucknow have been started. There is a huge scope for medical entrepreneurs to look at setting up more, stated Dr Pratibha Dabas, principal consultant, Healthcare, Technopak.
IGNOU offer a one year part-time, Post Graduate Diploma in Geriatric Medicine (PGDGM) and
IMA AKN Sinha Institute offers a certificate in geriatrics.
Source :- The Technopak report on Age-Sensitive Hospitals June 2012
Package of Services at different levels (SC/PHC/CHC/RGC)
Institutional framework for implementation
Integration with NRHM
State Health Society
District Health Society
C. Management Structure
National/ State / District NCD cell composition & responsibilities
D. Activities at various levels (SC/PHC/CHC/RGC)
Package of Services:
The range of services will include
Health promotion
Preventive services
Diagnosis and management of geriatric medical problems (out and in-patient)
Day care services
Rehabilitative services
Home based care
Districts will be linked to Regional Geriatric Centers for providing tertiary level care.
Integration with existing primary health care delivery system and vertical at district and above as more specialized health care are needed for the elderly.
Services at Sub-centre:
Health Education related to healthy ageing
Domiciliary visits to home bound / bedridden elderly persons .
Arrange for suitable calipers and supportive devices.
Linkage with other support groups and day care centers.
Services at PHC:
Weekly geriatric clinic by a trained Medical Officer
Conducting a routine health assessment (eye, BP, blood sugar & record keeping).
Provision of medicines and proper advice on chronic ailments
Public awareness on Geriatrics health
Referral services.
Services at District Hospital :
Geriatric Clinic for regular dedicated OPD services to the Elderly with Lab facility & adequate medicine.
10 bedded Geriatric Ward with existing specialties
Provide services to patients referred by the CHCs/PHCs etc.
Conducting camps in PHCs/CHCs and other sites.
Referral services to tertiary level hospitals
Services at Regional Geriatric Centre:
Geriatric Clinic (Specialized OPD)
30-bedded Geriatric Ward.
Laboratory investigation with a special sample collection centre in OPD block.
Tertiary health care to the cases referred from medical colleges, district hospitals and below.
Funds from Government of India will be released to the State Health Society.
State Health Society will retain funds for state level activity and release GIA to the District Health Societies.
NPHCE would operate through NCD cells under the programme constituted at State and District levels and also maintain separate bank accounts at each level. Funds from Health Society will be transferred to the Bank accounts of the NCD cell after requisite approvals at appropriate stage.
This system will ensure both convergence as well as independence in achieving programme goals through specific interventions. It is envisaged to merge the programme at State and District into the SHS and DHS respectively in order to ensure sustaining the current momentum and continued focus.
State Health Society (SHS):
Under the NRHM framework different Societies of national programmes such as
Reproductive and Child Health Programme, Malaria, TB, Leprosy, National
Blindness Control Programme have been merged into a common State Health
Society is chaired by Chief Secretary/Development Commissioner. Principal/
Secretary (Health & Family Welfare) is the vice chair person and mission director
is the Member -Secretary of the State Health Society.
District Health Society (DHS)
At the district level all programme societies have been merged into the District
Health Society (DHS).The Governing Body of the DHS is chaired by the Chairman
of the Zila Parishad / District Collector. The Executive Body is chaired by the
District Collector (subject to State specific variations).The CMHO is the Member
-Secretary of the District Health Society. District health society will pass on the
funds to the Rogi Kalyan Samities of Block level for the activities under the
programme. District Health society will monitor the utilization of funds and submit
quarterly the financial management report (FMR) of the programme to State
Health Society.
Responsibilities of the State/UT
Appoint a State Nodal officer for liaison with Central Government, various State & District authorities as well as Regional Medical Institutes.
Contribution of state share of 20%
Provision of land/space for the Geriatric ward & OPD
Setting up of State NCD Cell.
The NCD Cell will be responsible for overall planning, implementation, monitoring and evaluation of the different activities, and achievement of physical and financial targets planned under the programme in the State.
The Cell shall function under the guidance of State programme Officer (SPO-NCD) and will be supported by the identified officers/officials from the Directorate /Director General of Health Services.
SPO (NCD) will be a State level health official identified by the State government.
Supplementing the expenditure on equipments, drugs and consumables
Starting P.G. Course in Geriatric Medicine @ 2 seats per year Regional Medical Institutes (by the States in which the Regional Medical Institutes is located)
Setting up of rehabilitation unit at CHCs falling within the identified districts
Taking over the responsibility from central Govt. once the units are fully functional.
Provision of supportive faculty in specialties other than Internal Medicine
Provision of diagnostic support services like Laboratory, Radiological and other investigational facilities.
Responsibilities of the State/UT
Appoint a State Nodal officer for liaison with Central Government, various State & District authorities as well as Regional Medical Institutes.
Contribution of state share of 20%
Provision of land/space for the Geriatric ward & OPD
Setting up of State NCD Cell.
The NCD Cell will be responsible for overall planning, implementation, monitoring and evaluation of the different activities, and achievement of physical and financial targets planned under the programme in the State.
The Cell shall function under the guidance of State programme Officer (SPO-NCD) and will be supported by the identified officers/officials from the Directorate /Director General of Health Services.
SPO (NCD) will be a State level health official identified by the State government.
Supplementing the expenditure on equipments, drugs and consumables
Starting P.G. Course in Geriatric Medicine @ 2 seats per year Regional Medical Institutes (by the States in which the Regional Medical Institutes is located)
Setting up of rehabilitation unit at CHCs falling within the identified districts
Taking over the responsibility from central Govt. once the units are fully functional.
Provision of supportive faculty in specialties other than Internal Medicine
Provision of diagnostic support services like Laboratory, Radiological and other investigational facilities.
Responsibilities of the State/UT
Appoint a State Nodal officer for liaison with Central Government, various State & District authorities as well as Regional Medical Institutes.
Contribution of state share of 20%
Provision of land/space for the Geriatric ward & OPD
Setting up of State NCD Cell.
The NCD Cell will be responsible for overall planning, implementation, monitoring and evaluation of the different activities, and achievement of physical and financial targets planned under the programme in the State.
The Cell shall function under the guidance of State programme Officer (SPO-NCD) and will be supported by the identified officers/officials from the Directorate /Director General of Health Services.
SPO (NCD) will be a State level health official identified by the State government.
Supplementing the expenditure on equipments, drugs and consumables
Starting P.G. Course in Geriatric Medicine @ 2 seats per year Regional Medical Institutes (by the States in which the Regional Medical Institutes is located)
Setting up of rehabilitation unit at CHCs falling within the identified districts
Taking over the responsibility from central Govt. once the units are fully functional.
Provision of supportive faculty in specialties other than Internal Medicine
Provision of diagnostic support services like Laboratory, Radiological and other investigational facilities.
Responsibilities of the State/UT
Appoint a State Nodal officer for liaison with Central Government, various State & District authorities as well as Regional Medical Institutes.
Contribution of state share of 20%
Provision of land/space for the Geriatric ward & OPD
Setting up of State NCD Cell.
The NCD Cell will be responsible for overall planning, implementation, monitoring and evaluation of the different activities, and achievement of physical and financial targets planned under the programme in the State.
The Cell shall function under the guidance of State programme Officer (SPO-NCD) and will be supported by the identified officers/officials from the Directorate /Director General of Health Services.
SPO (NCD) will be a State level health official identified by the State government.
Supplementing the expenditure on equipments, drugs and consumables
Starting P.G. Course in Geriatric Medicine @ 2 seats per year Regional Medical Institutes (by the States in which the Regional Medical Institutes is located)
Setting up of rehabilitation unit at CHCs falling within the identified districts
Taking over the responsibility from central Govt. once the units are fully functional.
Provision of supportive faculty in specialties other than Internal Medicine
Provision of diagnostic support services like Laboratory, Radiological and other investigational facilities.
At PHC level:
The weekly geriatric clinic by trained medical officer.
Coordination with CHC, district hospital, sub centers, other National Health Programmes/ Departments for medicines, ambulances
Training of manpower & Separate registration counter for elderly.
Public awareness during health and village sanitation day/camps.
Provision of medicine to the elderly for their medical ailments.
At PHC level:
The weekly geriatric clinic by trained medical officer.
Coordination with CHC, district hospital, sub centers, other National Health Programmes/ Departments for medicines, ambulances
Training of manpower & Separate registration counter for elderly.
Public awareness during health and village sanitation day/camps.
Provision of medicine to the elderly for their medical ailments.
At PHC level:
The weekly geriatric clinic by trained medical officer.
Coordination with CHC, district hospital, sub centers, other National Health Programmes/ Departments for medicines, ambulances
Training of manpower & Separate registration counter for elderly.
Public awareness during health and village sanitation day/camps.
Provision of medicine to the elderly for their medical ailments.
At PHC level:
The weekly geriatric clinic by trained medical officer.
Coordination with CHC, district hospital, sub centers, other National Health Programmes/ Departments for medicines, ambulances
Training of manpower & Separate registration counter for elderly.
Public awareness during health and village sanitation day/camps.
Provision of medicine to the elderly for their medical ailments.
At PHC level:
The weekly geriatric clinic by trained medical officer.
Coordination with CHC, district hospital, sub centers, other National Health Programmes/ Departments for medicines, ambulances
Training of manpower & Separate registration counter for elderly.
Public awareness during health and village sanitation day/camps.
Provision of medicine to the elderly for their medical ailments.
At PHC level:
The weekly geriatric clinic by trained medical officer.
Coordination with CHC, district hospital, sub centers, other National Health Programmes/ Departments for medicines, ambulances
Training of manpower & Separate registration counter for elderly.
Public awareness during health and village sanitation day/camps.
Provision of medicine to the elderly for their medical ailments.
Geriatric Clinic with Specialized services: It will be the responsibility of the concerned regional institutions to organize specialized OPDs in all the specialties available with them for the benefit of the Elderly. Staff for the newly created Geriatric Clinic will be funded under NPHCE. All the other specialists will be from existing human resources of the institution. The Institution shall not wait for the commissioning of the building for provision of OPDs. They will have to start OPDs immediately on launch of this programme from within existing infrastructure.
Deployment of Specialists: Keeping in view the scarcity of specialist in geriatric field, the existing specialist in various fields who are either trained in geriatric or interested in the field be utilized for managing geriatric OPD and geriatric wards. Details of additional contractual staff for Regional Geriatric Centre supported under the programme are given below. Their recruitment will be made by the Medical Institution
Investigations: It will be the responsibility of the concerned regional institutions to provide for lab services, x-ray and other special investigation services for elderly. A special collection centre will be provided in the OPD block.
Drugs and Consumables: A provision of Rs 20 lakh per annum has been made for each Regional Geriatric Centre for Drugs and Consumables under the Programme. Any further expenses on this count shall be borne from the institutions/states own resources.
Referral Services: The institution will be responsible to provide tertiary health care to the referral cases from the medical colleges, district hospitals and below.
Training: Infrastructure and facilities, including audio-visual aids available in the institution will be utilized for various training courses envisaged under NPHCE.
Post-graduation in Geriatric Medicine: The institution will be responsible for initiating process for creating 2 post graduate seats for MD in Geriatric Medicine with affiliated Universities.
Research: The department will undertake clinical, epidemiological and applied research in the field of gerontology and geriatrics from the available grant under the programme. Areas of research will be finalized in consultation with National NCD Cell. Multi-centric studies will be encouraged for programme related research.
Guidelines have been developed in collaboration with WHO for management of 30 bedded geriatric ward and may be perused for running the Centre.
Geriatric Clinic with Specialized services: It will be the responsibility of the concerned regional institutions to organize specialized OPDs in all the specialties available with them for the benefit of the Elderly. Staff for the newly created Geriatric Clinic will be funded under NPHCE. All the other specialists will be from existing human resources of the institution. The Institution shall not wait for the commissioning of the building for provision of OPDs. They will have to start OPDs immediately on launch of this programme from within existing infrastructure.
Deployment of Specialists: Keeping in view the scarcity of specialist in geriatric field, the existing specialist in various fields who are either trained in geriatric or interested in the field be utilized for managing geriatric OPD and geriatric wards. Details of additional contractual staff for Regional Geriatric Centre supported under the programme are given below. Their recruitment will be made by the Medical Institution
Investigations: It will be the responsibility of the concerned regional institutions to provide for lab services, x-ray and other special investigation services for elderly. A special collection centre will be provided in the OPD block.
Drugs and Consumables: A provision of Rs 20 lakh per annum has been made for each Regional Geriatric Centre for Drugs and Consumables under the Programme. Any further expenses on this count shall be borne from the institutions/states own resources.
Referral Services: The institution will be responsible to provide tertiary health care to the referral cases from the medical colleges, district hospitals and below.
Training: Infrastructure and facilities, including audio-visual aids available in the institution will be utilized for various training courses envisaged under NPHCE.
Post-graduation in Geriatric Medicine: The institution will be responsible for initiating process for creating 2 post graduate seats for MD in Geriatric Medicine with affiliated Universities.
Research: The department will undertake clinical, epidemiological and applied research in the field of gerontology and geriatrics from the available grant under the programme. Areas of research will be finalized in consultation with National NCD Cell. Multi-centric studies will be encouraged for programme related research.
Guidelines have been developed in collaboration with WHO for management of 30 bedded geriatric ward and may be perused for running the Centre.
-
-
-
-
Objects of the trust - A brief note1) To provide shelter, conducive food, clothes, bed, medicines & other facilities to elderly men & women who are bereft of shelter, and without support and near-relatives, irrespective of caste, religion or creed. To formulate and execute schemes for the welfare of the old and personality development of such people. The executive committee of the trust is empowered to make exceptions, if any, in respect of beneficiaries & the services being provided to them.2) To extend co-operation to like minded institutions in pune or outside to enable them carry out the objectives enumerated in para. 1. Further if needed, to accept the management of such like minded institutions on the condition which are appropriate and in keeping with the objectives of the trust.3) To arrange entertainment programs for the inmates who have been given shelters by the trust and to arrange for their orientation and training so that their inherent capacities and qualities are fastened and enhanced.4) To make efforts for rehabilitating the inmates among their relatives if such possibilities are appearing and extend all possible help in this direction.5) To undertake training and consultative programs for the elderly so that they become needed and welcome in their homes only and new generation understand and welcome them in the homes. To institute a family consultation centered with this end and view.6) To extend necessary co-operation & help in the event of undertaking some programs irrespective of the problems of the elderly both on government level or on behalf of public/ private institution working in this field.7) To arrange and monitor studies and research regarding the issues of the old men and women or to extend helping hand in this regard.Institution established on 9th Aug 1863. Before that we met Mr. Devid Sasoon on 4th Aug 1863.Institution got the land possession legally on 3rd Feb 1864 and Mr. Devid Sasoon donated Rs.25000 on 20th Jul 1864. Due to that institution was named as on his name.Mr. Devid Sasoon has given written permission for his name to institute on 21st Aug 1864.