The document summarizes information about geriatric health and policies related to senior citizens in India. It discusses: 1) The definition and scope of geriatrics according to WHO. It also discusses the size of the geriatric population globally and in India. 2) Key policies and programs introduced by the Indian government to address the health and welfare of senior citizens, such as the National Policy on Older Persons, Maintenance and Welfare of Parents Act, National Program for Healthcare of the Elderly, and pension schemes. 3) It also outlines the role of NGOs like HelpAge India in providing services and care for senior citizens.

1. Geriatric health
PRESENTER – DR.NAVEEN SHYAM
JUNIOR RESIDENT
DR. SUSHILA NAYAR SCHOOL OF PUBLIC HEALTH
(INCORPORATING THE DEPARTMENT OF COMMUNITY MEDICINE)
MGIMS, SEWAGRAM, WARDHA, MAHARASHTRA, INDIA
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2. From the Greek "geron" meaning "old man" + "iatreia" meaning
"the treatment of disease.".
WHO definition: The branch of medicine concerned with the
diagnosis, treatment and prevention of disease in older people and
the problems specific to aging.
Geriatrics??
2

3. Simple words!!!
WHO -65 years and above
India ,"senior citizen“ - 60 years or above*
60 – 74 as young old
75- 84 as middle old
Above 85 as oldest old or infirm
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4. Global size of geriatric population
In the year 2019,
694 million in the world,
Italy -24%
Japan 16%
By 2025,
to rise more than 1.2 billion with about 840 million
of these in low-income countries
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5. Size of geriatric population- India
The population over the age of 60 years has tripled in last 50 years in India
census 2001
• 7.7% of the
total
population
census 2011
• 8.14%
Projected size
in 2050
• 19%
 In next 25-30 years people over 65 years of age would be
twice the number of children less than 5 years of age
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6. Population census data 2011
81% of the elderly population resides in rural
Literacy rate among elderly is 44%
Potential dependency ratio is 14.2%
Elderly below poverty line is 30%
6

7. The disability profile among the elderly
people – India
87.5% had minimal to severe disabilities
38.39% disabled have one disability
15.44% have two disabilities and
5.88% have three disabilities
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8. Geriatric problems
Problems due to the ageing process
Problems associated with long-term illness
Psychological problems
8

9. Problems due to the ageing process
senile cataract,
glaucoma,
Nerve deafness,
osteoporosis affecting mobility,
emphysema.
failure of special senses,
changes in mental outlook
9

10. Problems associated with long-term
illness
Degenerative diseases of heart and blood vessels
Cancer
Accidents
Diabetes
Diseases of locomotor system
Respiratory illnesses
Genitourinary system
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11. Psychological problems
Mental changes
Sexual adjustment
Emotional disorders
11

12. The I’s of geriatric morbidities
Instability
Inanition ( malnutrition )
Intellectual impairment
Impoverishment (! Earnings)
Incontinence
Incoherence (delirium)
Insulin resistance (DM)
Immobility
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13. Components of geriatric assessment
Physical
Functional
Psycological : cognitive , affective
Socioeconomic : financial , social support and care facility
Environmental
13

14. Principles of preventive geriatrics
Individual become more
and more heterogenous
or dissimilar as they age
Ageing doesn’t produce an
abrupt decline in organ
failure but the disease
always does
Ageing process is increased by
disease and can be decreased
by modification of risk factors
such as smoking, sedentary
lifestyle and obesity
Investigation is essential tool
for diagnosis but under or
over investigations to be
avoided
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15. Lifestyle and healthy ageing
Diet and
nutrition
Exercise Weight Smoking Alcohol
Social
activities
15

16. Global policies
WHO introduced the concept of ageing in 2002.
In the world report on ageing 2015 , the concept of healthy ageing from 2015-
2030 was adapted
WHO defines healthy ageing as “the process of developing and maintaining the
functional ability that enables wellbeing in older age.”
Functional ability is about having the capabilities that enable all people to be
and do what they have reason to value.
1st October – International day of older persons
15th June – world elder abuse day
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17. Global policies
A comprehensive Global Strategy and Action
Plan on Ageing and Health was developed by
WHO in consultation with Member States and
other partners in May 2016 emphasizing on
healthy aging
The Strategy and Action Plan draws on the
evidence of the World report on ageing and
health and builds on existing activities to
address 5 priority areas for action.
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18. Global Strategy and Action Plan on
Ageing and Health
18

19. 19

20. Indian governmental policies
The ministry of social justice and empowerment (MOSJE) deals with the social
issues of elderly.
The ministry of health and family welfare (MOHFW) addresses the health
concerns.
The key initiatives undertaken by the GOI are
1. National Policy on Older Persons (NPOP) – 1999,2011
2. Maintenance and welfare of parents and senior citizens – 2007
3. National Program for Health Care of the Elderly (NPHCE) – 2010
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21. National Policy on older persons
The government of India announced a National Policy on older persons in
January 1999, focusing on well- being of elderly
In 2011 , NPOP was revised to value an age integrated society
This policy identifies principal areas of intervention as financial security, health
care, nutrition, shelter, education, welfare, protection of life and property of
older citizens
Also includes involvement of NGOs, training the manpower , establishment of
National Council for Senior Citizens,
21

22. National Policy on older persons
A national council for older persons (NCOP) was constituted to operationalize
the policy.
The program for the first time recognizes formation of self-help groups,
association of older persons for advancement of their rights and utilization of
their experience and services.
234 Old age homes, 398 day care centers and 40 mobile medical units were
operational.
22

23. NPOP
The Ministry of Social Justice and Empowerment (MOSJE) coordinates the implementation of
NPOP while many elements of the Policy are under the mandates of several other ministries.
After about a decade of implementation of NPOP, the MOSJE set up a committee of experts to
review implementation, experience and suggest ways and means for improving the policy
content and its implementation.
The expert committee has prepared a revised National Policy for Senior Citizens (NPSC) which
recognizes that
(a) elderly women need special attention,
(b) rural poor need special attention and
(c) factoring the advancements in medical technology and using it in the revised policy
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24. Maintenance of senior citizens act ,2007
There is a legal compulsion for children and successors to offer maintenance to
senior citizens and parents, by monthly allowance
Children or grandchildren or relative are under obligation to look after his or
her parent either father or mother or both or relative.
If such children or relative is not maintaining his parent or senior citizen, then
the parents or senior citizen can seek the assistance of a court of law under this
act
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25. Indian policies
On 19th Nov. 2007, the Indira Gandhi National Old Age Pension Scheme was launched to
provide monthly pension to people over 65 years and living below poverty line. The scheme is to
cover about 1.57 crore people.
Health care is being provided to the older persons through Bhavishya Arogya Mediclaim, and
Rural Group Life Insurance Schemes. Income Tax Concessions are also available to the elderly
citizens.
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26. Indian policies
As a part of National Social Assistance Program, old age pension is being
provided to more than 4 million elderly all over the country.
An Old Age Social and Income Security (OASIS) project was launched to
comprehensively examine policy questions, connected with Old Age Income
Security
Travel related concessions facilities are provided to the older people by Indian
Railways, Indian Airlines and State Transport Corporations.
26

27. THE NATIONAL PROGRAM FOR THE
HEALTH-CARE FOR THE ELDERLY (NPHCE)
The NPHCE is an articulation of the International and national commitments of
the Government as said under the UN Convention on the Rights of Persons
with Disabilities,
 National Policy on Older Persons (NPOP)adopted by the Government of India
in 1999 and
Section 20 of “The Maintenance and Welfare of Parents and Senior Citizens
Act, 2007” dealing with provisions for medical care of Senior Citizen
27

28. SPECIFIC OBJECTIVES OF NPHCE
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”
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29. SPECIFIC OBJECTIVES OF NPHCE
To promote the concept of Active and Healthy
Ageing
Convergence with National Rural Health Mission,
AYUSH and other line departments like Ministry of
Social Justice and Empowerment
29

30. Program Strategies
Community based primary health care approach including domiciliary visits by
trained health care workers.
Dedicated services at PHC/CHC level including provision of machinery,
equipment, training, additional human resources.
Dedicated facilities at District Hospital with 10 bedded wards, additional
human resources, machinery & equipment, consumables & drugs.
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31. Program Strategies
Strengthening of Regional Geriatric Centers to provide dedicated tertiary level
medical facilities for the Elderly, introducing PG courses in Geriatric Medicine,
and in-service training of health personnel at all levels.
Information, Education & Communication (IEC) using mass media, folk media
and other communication channels to reach out to the target community.
Continuous monitoring and independent evaluation of the Program and
research in Geriatrics and implementation of NPHCE
31

32. Package of Services
Sub Centre: Health Education and home based care to bedridden elderly persons
and provide training to the family health care providers in looking after the
disabled elderly persons.
Primary Health Centre: Conducting weekly geriatric clinic - health assessment of
the elderly persons and simple investigation including blood sugar, etc.
Community Health Centre: Conducting biweekly geriatric clinic, organizing
rehabilitation services, domiciliary visits by the rehabilitation worker for bed-
ridden elderly and counselling to family members for care such patients.
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33. Package of Services
District Hospitals: Dedicated Geriatric OPD services, In-door
admissions through 10 bedded geriatric ward, laboratory
investigations and rehabilitation services
Regional Geriatric Centers: Providing tertiary care services through
OPD and in-door admission in 30 bedded ward, development of
specialized human resource through MD courses in geriatric
medicine as well as research
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34. Expected Outcome of Programme
Establishment of Department of Geriatric Medicine in selected 19
Medical Colleges Sanctioned as Regional Geriatric Centers (RGC) – 30
bedded ward + 2 PG seats
District Geriatric Units with dedicated Geriatric OPD -10 bedded
Rehabilitation/Physiotherapy Services in all District Hospitals.
OPD Clinics/Rehabilitation units at CHC, PHC & HWC.
Health & Wellness Centers/Sub-centres provided with equipment for
community outreach services for Elderly.
34

35. Progress in implementation of Program
Expansion of primary & secondary Geriatric care services to all districts :
11th plan period 100 districts had been sanctioned for NPHCE services
12th plan period - 421 districts.
2019-20,all 718 districts have been sanctioned for geriatric primary & secondary
care services of OPD, IPD, Physiotherapy and laboratory services
35

36. Tertiary level activities of NPHCE
Renamed as ‘RashtriyaVaristh Jan Swasthya Yojana’ in 2016-17.
As on date, 19 Regional Geriatric Centres (RGCs) in selected Medical Colleges of
18 States.
Presently OPD services are being provided through 18 RGCs, inpatient services in 16 RGC’s,
Physiotherapy in 14 centers & laboratory services in 13 centers.
Two National Centre for Ageing (NCA) has also been developed as center of
Excellence for Geriatric Care services.
200 bedded NCA at Madras Medical College, Chennai has been developed and operational for
Covid ward and another NCA at AIIMS, New Delhi is in advance state of Construction services are
expected to initiate by October 2021. A 250 Bedded Geriatric Care and Rehabilitation Centre is
sanctioned at PGI Chandigarh.
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37. Training Modules
Three sets of Training modules for Medical Officers, Nurses and Community
based workers to deliver Comprehensive Geriatric care has been developed.
State level Training of Trainers of Medical Officers for Comprehensive Geriatric
Care has been conducted at Chhattisgarh, Meghalaya, Haryana, Punjab, Tamil
Nadu & Maharashtra
generating approx. 236 States level Master Trainers and 85 National Master
Trainers
27 for Medical Officer Module, 26 for Staff Nurses Module and 32 for module
developed to train Community based workers.
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38. Rashtriya Varishth Jan Swasthya Yojana
(RVJSY)
Development of a home health care service
Development of a service for “yoga” therapy for senior citizens
Convergence with AYUSH interventions
Screening for early diagnosis
Special IEC activities targeting the very old and their care-givers
“Mobile elderly” project
Vaccination project for 75+
38

39. NPHCE- my views
Although, the NPHCE addresses most of the health problems in an institutional
health-care system, still more emphasize should be on the home based
management system.
Other than having a national vision, the policy should have a decentralized
vision.
The policy can be a failure in addressing how to generate an incentive for
families to treat and care for their elderly.
39

40. The Annapurna scheme
The Ministry of Rural Development launched the scheme in 2000-2001
The Annapurna Scheme aims at providing food security to meet the
requirement of those Senior Citizens who though eligible have remained
uncovered under the National Old Age Pension Scheme (NOAPS).
 Under the Annapurna Scheme, 10 kg. of food grains per month are to be
provided free of cost' to the Beneficiary
40

41. Rashtriya vayoshri yojana
RVY is a scheme funded from senior citizen welfare fund since 2016
Under RVY, devices to assist in living with disability to elderly persons of BPL
category who are facing age related disabilities are given.
It is executed by Artificial Limbs Manufacturing Corporation of India (ALIMCO)
which is under the ministry of social justice and empowerment
The beneficiary identification will be done by a committee at the district level
headed by the district collector and kits will be provided in the camps
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42. The Pradan Mantri Vaya Vandana yojana
It was launched in May 2017 to ensure provision of social security in elderly person
It is implemented by LIC of India
Under this scheme on payment of an initial lump sum amount ranging from rs.1.5 lakhs for a
minimum pension of Rs 1000 per month to rs.15 lakhs for a maximum of rs.10000 per month.
42

43. Pension Schemes
Pension Schemes For Senior Citizens Offered By The Government of India
APY – Atal Pension Yojana.
NPS – National Pension System.
VPBY – Varishtha Pension Bima Yojana.
43

44. NGOs
Here are a few Give Assured senior citizen NGOs which are trying to help elderly and making
sure that they are taken care of in their old age.
Manavlok
HelpAge India
Abhoy Mission
Shraddhanand Mahilashram
Asha Kiran.
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45. NGOs
HelpAge India is the largest voluntary organization working for the cause and care of the
disadvantaged older people. In the 26 years since its start. It has made an impact on the lives of
nearly 6 million senior citizens, through 3,084 projects.
Free cataract operations;
Mobile Medicare units;
Income generation and micro-credit;
Old-age homes and day-care centers;
Adopt-a-Gran(grand parent); and
Disaster mitigation
45

46. LASI Project
A Longitudinal Ageing Study in India (LASI) Project is presently being
undertaken by International Institute for Population Sciences, Mumbai, an
autonomous body under the Ministry of Health and Family Welfare.
This long term comprehensive survey will assess the health status of the
elderly (age 45-60) and shall be a longitudinal study spanning 25 years.
This project shall be conducted under the Joint Sponsorship of
o Ministry of Health and Family Welfare, Ministry of Social Justice
Empowerment,
oNational Institute of Health/National Institute on Ageing, USA and
o United Nations Population Fund (UNFPA) – India.
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47. LASI Project
The main objective of the LASI is to provide a comprehensive scientific evidence
base on
demographics, household economic status,
chronic health conditions, symptom-based health conditions, functional
health, mental health (cognition and depression), biomarkers,
health insurance and healthcare utilization, family and social networks,
social welfare programs,
work and employment, retirement satisfaction, and life expectations
47

48. LASI Project
the use of Computer Assisted Personal
Interview (CAPI) technology for data
collection, quality control and geographic
information system (GIS) use. No other
survey in India collects detailed data on
health and biomarkers together with data
on family and social network, income,
assets, and consumption.
48

49. LASI Project
49

50. LASI Project
50

51. LASI Project
51

52. Covid 19 and elderly
The COVID-19 situation affected the health condition of 26 per cent of the
elderly population in the country.
24.95 per cent said the pandemic has caused psychological distress.
"About 37.8 per cent elderly women in comparison to 33.2 per cent elderly
men were reportedly found enjoying better health
less than one-fourth elderly (23.6 per cent) confirmed that they are being
benefitted under one or more government-sponsored healthcare schemes.“
52

53. LASI Project
53

54. References
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55. References
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es_NPHCE_final.pdf
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17. Five Year Plan. 2. The estimated cost of the tertiary level activities of
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https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf
19. Five Year Plan. 2. The estimated cost of the tertiary level activities of
the programme are as per details *Expenditure during 12. 2016;(ii):1–5.
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56. Thank you
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