CAREER IN ELDERLY CARE

Dr. R. Giriraj

In India the size of the elderly population, i.e. persons above the age of 60 years is fast growing. The elderly who accounted for 6.7 percent of total population are expected to grow over 10 percent by 2021. For a developing country like India, this may pose mounting pressures on various socio economic fronts including pension outlays, health care expenditures, fiscal discipline, savings levels etc. Again this segment of population faces multiple medical and psychological problems. There is, therefore, an emerging need to pay greater attention to ageing-related issues .   

Although elderly Care is inbuilt in the value system of Indian culture, taking care of the elderly in terms of social, economical, medical and psychological aspects has become a challenge. This is despite improved health care system and supports for unprecedented longevity. In order to create a supportive environment for the well-being of elderly, Government of India is fully committed and is playing a vital role in formulating and implementing policies in order to create an enabling environment for the older persons to lead an active and productive life. The Ministry of Social Justice and Empowerment, as the nodal Ministry with regard to ageing issues, provides basic policy guidelines and the roadmap for their implementation. It also coordinates with stakeholders such as the other Ministries of the Central and the State Governments, NGOs, civil society institutions etc.

Magnitude of the problem

Currently, Asia has the largest number of world's elderly. This pressure of increasing number of elderly is expected to intensify in the next 50 years. In India as per 2011 Census, the population of Senior Citizens is 104 million constituting 8.6% of the total population. By 2026, the populationof Senior Citizens is expected to reach 173 million constituting 12.4 per cent of the total population. The share of people aged 60 years and above in the total population as per Census 2011, works out to 10.38 crore out of 121.05 crore constituting 8.57per centof the total population. Out of 62.31 crore male population, elderly males are 5.10 crore constituting 8.20per cent while out 58.74 crore female population, 5.28 crore are females elderly constituting 8.99per centof total female population of the country.

Continuous increase in life expectancy means that more people are now living longer. General improvement in the health care facilities over the years is one of the main reasons for continuous increase in proportion of population of senior citizens. Ensuring that they do not merely live longer, but lead a secure, dignified and productive life is a major challenge.

Constitutional and Legislative 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 and disablement, and in other cases of underserved want.

 The Maintenance and Welfare of Parents and Senior Citizens Act, 2007 was enacted in December 2007 to ensure need based maintenance for parents and senior citizen sand their welfare. The Act provides for :

(a)   Maintenance of Parents/ senior citizens by children/relatives made obligatory and justifiable  through                     Tribunals,

 (b)   Revocation of transfer of property by senior citizens in case of negligence by relatives, (c)Penal provision for abandonment of senior citizens,

 (c)   Establishment of Old Age Homes for Indigent Senior Citizens and

 (d)    Adequate medical facilitie sand security for Senior Citizens.

National Policy on Older Person.

Government of India announced the National Policy on Older Persons (NPOP) in 1999 to reaffirm its commitment to ensure the wellbeing of the older persons. The Policy envisages State support to ensure financial and food security, health care, shelter and other needs of older persons, equitable share in development, protection against abuse and exploitation, and availability of services to improve the quality of their lives.

National Council for Older person

A National Council for Older  Persons1999 (NCOP) was constituted under the Chairmanship of the Union Minister of Social justice and Empowerment to oversee the implementation of the Policy.

Integrated Program for Older Persons

The Nodal Ministry implements the Central Sector Scheme of Integrated Programme for Older Persons (IPOP) under the Scheme, financial assistance up to 90% and in case of state 95per cent of the project cost is provided to  Government/ Non-Governmental Organizations/ Panchayati Raj Institutions/ local bodies etc. For establishing and maintaining old age homes, day care centres and mobile Medicare units. Several innovative projects have been added as being eligible for assistance under the Scheme, some of these are Maintenance of Respite Care Homes and Continuous Care Homes, Running of Day Care Centres for  Patients, Physiotherapy Clinics for older persons, Help-lines and Counselling Centres for older persons,Sensitizing programmes for children particularly in Schools and Colleges, Regional Resource and Training Centres, Training of Caregivers to the older persons, Awareness Generation Programmes for Older Persons and Care Givers,  Formation of Senior Citizens Associations etc.,

Programs of Other Ministries

The Rural Ministry is implementing the Indira Gandhi National Old Age Pension Scheme (IGNOAPS) under which Central assistance is given towards pension @ Rs. 200/- per month to persons above 60 years and @ Rs. 500/- per month to persons above 80 years belonging to a household below poverty line and matching contribution/ equal contribution is given by State Govts. The Ministry also administers the Annapurna Scheme under which free food grains (wheat or rice) upto 10 kg. per month are provided to destitute older persons of 65 years or above who are otherwise eligible for old  age pension but are not receiving it. Ministry of Health and Family Welfare provides the facilities for senior citizens such as Separate queues for older persons in Government hospitals and Geriatric clinic in several government hospitals. The Ministry is implementing the National Programme for the Health Care for the Elderly (NPHCE). Ministry of Finance provides Tax benefits for senior citizens. Ministry of Home Affairs in its advisories has advised the States/UTs to take immediate measures to ensure safety and security and for elimination of all forms of neglect, abuse and violence against older Person. Ministry of Railways extends the facilities to senior citizens such as Separate ticket counters for senior citizens of age 60 years and above, 40per cent and 50per cent concession in rail fare for male (60 years) and female (58 years) senior citizen respectively and Wheel chairs at stations for old age passengers. Air India under the Ministry of Civil Aviation provides air fare concession up to 50per cent for senior citizens. The Department of Pension has set up a  Pension Portal to enable senior citizens  to get information regarding the status of their  aplication, the amount of pension, document required, if any, etc.. The Ministry of Law and Justice has directed the High Courts in the country accord priority to cases involving older persons and ensures their expeditious disposal.

Professional service to Elderly

Elderly Care profession is more suitable to students of social Science faculty, particularly, Social Work Education. Social work is a professional service that seeks to improve the quality of life and enhance well being of individuals including elderly people. Considerable percentage of elders suffer from life style disease like diabetes, hypertension, heart and lung diseases. They need professional support/care for their for  doing daily activities.. Elderly Care is, therefore, one of the upcoming profession for providing  professional  assistance for every day living of elders and this requires more attention, dedication and commitment in addition to technical knowledge and experience. Elderly care givers has more job potential in metropolitan Cities. Earlier, the elderly care used to be the responsibility of their family. This practice is still intact in the rural areas. However, in urban areas ,especially, in states like Kerala, Punjab, Tamil Nadu and Andhra Pradesh there have been a large number of senior citizens living without their children to look after them. Given the fact that 70per cent of such elders live with one or other or multiple ailments require assisted living support for performing their Activities of Daily Living-(ADL). Elders affected with terminal illness, People living with all forms of Dementia, Parkinson’s disease etc., require specialized person centric care. These conditions have thrown a vast opportunity for short term and long term care givers, bedside assistants, semi-qualified nursing assistants, day time carers and 24 X7 carers etc. eeping in view of rising demand, National Institute of Social Defence(NISD), Ministry of Social Justice and Empowerment is engaged in training the eligible person on elderly/Geriatric Care to generate pool of geriatric Care givers in order to assist the elders who are in need. NISD has been training eligible persons on elderly /Geriatric Care and also through its Regional Resources Training Centres (RRTCs) located at Delhi, Kolkata, Mumbai, Imphal, Bangalore, Hyderabad and Coimbatore. There are very few institutions which offer such needs based training focusing elderly care. The Old Age care Division of National Institute of Social Defence is a unique Institution which offers customized courses on following streams with a view to cater to the above emerging needs.

1. Three Month Certificate Course on Geriatric Care is offered for those with minimum 10 pass qualification. People particularly married women, widows, person who have inclination to work for the elders, transgender may also apply for above course and work as individual

Home Care giver/taker of elderly. There is job opportunity in Old Age Homes which are mushrooming in the country. Further, they can be absorbed in the Hospitals also as helpers and NGOs working in the field of elderly care.

2. Six Month Certificate Course on Geriatric Care is offered for those with +2 qualifications. It has job potential in Old Age Homes/Day Care Centres including palliative care units to work as Geriatric Care givers/palliative helper and supervisors in related NGOs.

 3. One year Post Graduate Diploma in Integrated Geriatric Care (PGDIGC) is offered for those who have completed under graduation. PGDIGC will help them work in Old Age Homes as geriatric care managers and offer specialised services such as Conducting care-planning assessments to identify needs, problems and eligibility for assistance, research on ageing, screening, arranging, and monitoring in home help and other services. It also provides for reviewing financial, legal or medical issues, offering referrals to specialists to avoid future problems and to conserve assets, providing crisis making sure things are going well and alerting families of problems. Assisting with moving their clients to or from a retirement complex, assisted living facility, rehabilitation facility or nursing home, providing client and family education and advocacy and offering counselling and support. They also have job opportunity in leading NGOs working on elderly issues as programme assistants/coordinators. Each course above has its own criteria defined based on the duration and course curriculum. Youngsters with basic minimum qualification can opt for appropriate course and after completion they are absorbed into this emerging market of care of elderly. The Institute is also exploring more options to cater to the special Emerging needs of the elderly.

The Author is Dy. Director (Old Age Care), National Institute ofSocial Defence, Ministry of Social Justice & Empowerment, New 

Delhi