Union government is planning a massive upgrade of the infrastructure and healthcare manpower under the National Programme for the Health Care of the Elderly (NPHCE). This would see the need to establish geriatric wards and geriatric clinics at various levels of the district healthcare delivery system.

Geriatric units with 10 beds at district hospitals and elderly clinics twice a week at the Community Healthcare Centres (CHCs) are planned. In addition, eight regional centres with geriatric wards and manpower training are being established across the country. These are at All India Institute of Medical Sciences (AIIMS), New Delhi; Institute of Medical Sciences, Banaras Hindu University, Uttar Pradesh; Sher-e-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir; Government Medical College, Thiruvananthapuram, Kerala; Guwahati Medical College, Guwahati, Assam; Madras Medical College, Chennai, Tamil Nadu; SN Medical College, Jodhpur, Rajasthan, besides Grant Medical College and JJ Hospital, Mumbai, Maharashtra.

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.

Currently, India has the second largest elderly population in the world. According to official population projections, the number of elderly persons will rise to approximately 140 million by 2021. Over the next four decades, India’s demographic structure is expected to shift dramatically from a young to an ageing population resulting in 316 million elderly persons by 2050, she said.

Common ailments among the Geriatric population are hypertension, heart diseases, cancers, osteoarthritis, hearing impairments, cataract, respiratory problems, nutritional problems, diabetes, tuberculosis, and mental morbidities. Elderly persons in India often succumb to preventable conditions like bronchitis, asthma, and pneumonia.

The Technopak report on Age-Sensitive Hospitals: Need and Opportunity states that an absence of human and institutional capacity for geriatric care in the Indian healthcare system contributes to variations in morbidity and access to care. Both outpatient visits and hospitalizations of the 60+ age-group are more than three times that for the general population leading to higher expenditure on healthcare. Almost 20 per cent of doctor’s visits, 30 per cent of hospital days and 50 per cent of bedridden days are related to elderly patients. India’s old are hospitalized for an average of 32 days.

Further, the geriatric population takes an average of six prescription drugs concurrently and often suffer from adverse drug reactions. Increase of morbidity associated with chronic non-communicable diseases due to increased life expectancy requires providers to keep pace with the higher demands of the ageing population on the system, reports Technopak.

Indian medical colleges should now introduce Geriatric specialization on similar lines that of the developed world, like the US. Till recently, in India, only one educational institution in Chennai offered a post-graduate degree in geriatric medicine. Others such as IGNOU offer a one year part-time, Post Graduate Diploma in Geriatric Medicine (PGDGM) and IMA AKN Sinha Institute offers a certificate in geriatrics. Most of the elderly patients are treated in general medical wards for want of infrastructure and specialists, stated Dr Dabas.