The document discusses the demography and health status of elders in India. It notes that as of 2001, 7.4% of the Indian population was over age 60, projected to rise to 12.4% by 2026. Life expectancy is higher for females, around 64 years, than males at 62.6 years. The document also outlines health challenges faced by elders such as physical mobility issues, heart disease, and disabilities. It provides recommendations for routine health screenings for elders.

1. Demography of elders in
India
Bivin Jay B, MSN
Mar Baselios College of Nursing
Kothamangalam

2. • National policy on elder persons (Jan
1999)
• National Sample Survey Organization,
India (2007-2008)- Demographic data are
related to life expectancy & age-specific
death rate
• National family health surveys- data
related to socio-economic status & health
conditions of the elders (2001)

3. • Elderly population (Age>60 Yrs)- 7.4% of
total population in the yr 2001
• Males= 7.1% & Females=7.8%
• More (10.5%) was in Kerala state
• Projected rise is about 12.4% by the yr
2026
• The life expectancy at birth was 64.2 for
females as against 62.6 yrs for males
(2006)
• Continues

4. • At age 60 average remaining length of life
was found to be about 18 yrs (16.7 for males,
18.9 for females)
• At age 70 remaining life was less than 12 yrs
(10.9 for males and 12.4 for females).
• Productivity:
• Less than 20% of elderly women but majority
of elderly men were economically
independent.
• Monthly per capita expenditure was between
Rs 420-Rs775 (Rural) & between Rs 665-
Rs1500 (urban) in 2006.
• Continues

5. • 66% of elder men & 23% of elder women
in rural area are still economically active
whereas it is 39% men & 7% women in
urban areas
• Physical problems:
• In rural areas 55 % of the aged with
sickness; in urban areas it is 63%
• 72% of the men & 63-65% of the women
ageing 60-64 yrs were physically mobile.
• About 65 % had to depend on others for
their ADLs
• Continues

6. • Medical illness:
• Heart disease among elders are higher in
urban areas than rural areas
• About 64/1000 in rural & 55/1000 in urban
areas suffer from one or more disabilities
• 63% of the disability is motor disability
• Psychosocial:
• >75% of elder males & <40% of the
females live with their spouses.
• <20% of the aged men & about 50% of the
women live with their children

7. 1. Ministry of Statistics, Govt. of India (2011)
Situation analysis of elderly in India. New
Delhi, Central statistical Institute.

8. Bivin Jay B, MSN
Mar Baselios College of Nursing
Kothamangalam

9. • Assessment ranges from simple screening
tests to in-depth evaluations
• Health assessment include health history,
physical examination & lab investigations
• Many structured assessment formats/tools
are available
• Interviewing an elder
– Prepare the physical settings
– Establish the rapport
– Structure the interview

10. Screening tests Recommendations
Blood pressure Every clinical
examination/ q1-2 yr
Clinical breast
examination
Annually (if >40 Yrs)
Mammogram q1-2 yrs if 50-69 yrs
q1-3 yrs if 70-85+ yrs
Pelvic exam/Pap smear q2-3 yrs; (after 3 –ve
tests, can decrease)

11. Screening tests Recommendations
Cholesterol Every 5 yr
Rectal examination Annually (if >40 Yrs)
Fecal occult blood Annually (if >50 Yrs)
Sigmoidoscopy Annually (if >50 Yrs)
Prostrate examination q3-5 yr (if <50 Yrs)
Annually (if >50 Yrs)
Tests for hearing/
vision/thyroid/EKG/Gluc
ose etc
Periodically
Exam of heart/lungs/
skin etc
Periodically

13. • Cornell scale for depression and dementia
• Short test for dementia
• Functional activities questionnaire
• Clinical dementia rating scale
• Information questionnaire on cognitive
decline in the elderly
• Confusion assessment method

14. • Wold GH (2008) Basic Geriatric Nursing,
4th Ed., Missouri, Mosby Elsevier Inc.

15. Bivin Jay B, MSN.
Mar Baselios College of Nursing
Kothamangalam

16. • Presently, the youth culture is prominent &
devaluation of elderly in the society
• Older adults- drain on the resources of the
nation
• Elder abuse is a serious, under reported,
under-detected phenomenon affecting a lot of
people
• 1.2-1.5 millions are victims of abuse/year
• 1/5 cases remain under reported (Ice berg
phenomenon)

17. • Physical: the use of physical force that
may result in bodily injury, physical pain or
impairment (26%)
• Sexual: nonconsensual sexual contact of
any kind
• Emotional/psychological: infliction of
anguish, pain or distress through
verbal/nonverbal acts (35%)
• Continues

18. • Neglect: the refusal/failure to fulfill any part
of a persons obligations or duties to an
older person (49%)
• Abandonment: the desertion of an older
person by an individual who has physical
custody of the elder or by a person who has
assumed responsibility for providing care to
an elder (3%)
• Self-neglect: behavior of an older person
that threatens his/her health or safety
• Exploitation/financial abuse (30%)

19. PHYSICAL ABUSE
• Unexplained bruises
– On face/lips/mouth
– On torso/back/buttocks or thighs
– In various stages of healing
– Clustered forming regular patterns
– Reflecting the shape of the article used to
inflict
– On several different surfaces

20. • Unexplained burns
– Cigarette burning (on soles,palms, back, or
buttocks)
– Immersion burns (on buttocks/genitals)
– Patterned like electric burner, iron & so on
• Unexplained fractures
– To skull/nose or other facial structures
– In various stages of healing
– Multiple/spiral fractures
• Unexplained lacerations/abrasions

21. PHYSICAL NEGLECT
–Consistent hunger, poor hygiene
–Inappropriate dress
–Consistent lack of supervision,
especially in dangerous activities for a
long
–Consistent fatigue/restlessness
–Unattended physical problems or
medical needs
–Abandonment
• Continues

22. • SEXUAL ABUSE
–Difficulty in walking or sitting
–Torn, stained, or bloody underclothing
–Pain/itching in genital area
–Bruises/bleeding in the ext genitals
• EMOTIONAL ABUSE
–Habit disorders (thumb sucking/biting
etc)
–Conduct dis. (antisocial/destructive)
–Sleep pblm/speech etc
–Hysteria, obsession, compulsion,
phobias etc

23. Safety
Access to care
Cognitive status
Emotional status
Health & functional status
Social/financial status

24. • Triage based on the need for emergency
attention
• Report to the legal authorities if confirmed
• Investigations are further made once the
elder is stable
• Community awareness campaign
• Rehabilitation might be difficult since the trust
being shattered among elders
• Ongoing surveillance is essential

25. 1. Meiner SE & Lueckenotte AG (2006)
Gerontologic Nursing. 3rd Ed., Missourie,
Mosby Elsevier
2. Stanley M, Blair KA & Beare PG (2009).
Gerontological nursing- promoting
successful aging with older adults, 3rd
Ed., Philadelphia FA Davis Co.