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Care facilities for elderly people in Odisha

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This article discusses the growing concern regarding the care of the elderly in India, focusing specifically on the situation in Odisha. Despite government programs aimed at supporting older individuals, many face economic challenges, especially in rural areas, leading to dependence and poverty. The paper highlights the need for enhanced geriatric healthcare facilities within communities, better financial security for the elderly, and the importance of evaluating care needs to provide optimal support.

ISSN 2397-5628 Journal of Geriatric Care and Research 2017, Vol 4, No 1 Insight Care facilities for elderly people in Odisha Namita Rath, Prasanta Kumar Biswal, Susen Kumar Panda Introduction Like most parts of the world, there is growing concern about the care perspectives of an ever increasing population of elderly in India.1 While progress is visible in the health care sector in general, however it is mostly targeted for urban, working age adults and children. Supporting systems for older people is still at a rudimentary level in most part of the country. Although the awareness of the need is gradually expanding, the extent and gravity of the current situation remains mostly unclear. There are many specific programmes, policies and laws which have been put into place in recent years. It remains to be studied how far those initiatives have made any changes in the lives of the elderly. In this article, supporting programmes in India are mentioned with specific discussion about the state of care facilities in Odisha, an Eastern state of India. Supportive programmes for elderly Central and State Governments in India have established various programmes for the welfare of the elderly in recent years (Box 1). These actions are providing some framework to ensure financial, health and social support to the vulnerable older persons, to protect and empower them with options. Box 1: Government initiatives Maintenance and Welfare of Parents and Senior Citizens Act of 2007. 2 National Policy for Older Persons (NPOP), 1999. 3 Indira Gandhi National Old Age Pension (IGNOAP) 4 Indira Gandhi Widow Pension (IGNWP) 4 Indira Gandhi National Disability Pension (IGNDP) 4 National Family Benefit Scheme (NFBS) 4 National Programme for Healthcare of The Elderly (NPHCE) 5 Integrated Programme For Older Persons (IPOP) 6 Senior Citizens’ Security Cells (SCSC) Status in Odisha According to the 2011 Census, 9.5 per cent of Odisha’s population consists of the people over 60, compared with 8.6 per cent in India. 32 Besides higher proportion of elderly population the situation is compounded with greater vulnerability of the population due to various other factors. Odisha is home to frequent natural disasters, which affects its economic status. It is no wonder that most of the elderly are financially compromised; most of them do not have work related pensions or government support. Reportedly almost 80% of elderly continue to work for their subsistence; figures are higher for rural areas (81.2%) compared with that of urban areas (65.5%).7 This leads to dependence on others and poverty. It is known that older persons are vulnerable for abuse, emotional, verbal, physical, and neglect. These are reported to be common in Odisha too.8,9 A survey conducted by United Nations Populations Fund, reported that one out of ten people above 60 years of age experience abuse in Odisha.7 These abuses are not reported usually; older persons downplay or hide these incidences as it is elsewhere. It is good to learn that there are Senior Citizens’ Security Cells (SCSC) in certain police station areas in Odisha, to provide support and security to older persons.10 Health care for the elderly Older people are more prone to physical and mental health problems. A range of health care facilities are available in Odisha e.g. the state-funded primary and secondary care including tertiary level hospitals which caters to the general population; in addition, many private hospitals are available mostly in cities. There have been initiatives to open specific health facilities like geriatric outpatients and wards in hospitals; however these are still to make an effective impact at ground level for the larger population throughout the state. Day care and old age homes There are many old age homes and day care centres in Odisha which have been established and are primarily being run by Non-Governmental Organisations (NGO), however there are hardly any in Government Sector. Most of these homes are operating in only a few districts. It is apparent that the present number of old age care homes is not enough for the state. While the facilities are available in neighbouring states, accessing old age homes in other states is fraught with Rath et al, 2017 moving away from native place and relatives, language barrier, and possible cultural differences. Besides, within the state, most facilities are available in the cities and towns, and there is hardly any in villages where most elderly people live.11,12 Poor infrastructure and lack of professional carers,13 especially in small towns and villages are other reasons. It appears obvious that more number of old age care centres should be established locally, to meet the needs of the elderly closer to home. Factors affecting care of elderly Joint family system which was common in India and the elderly enjoyed a respectable position in the family is now disintegrating gradually into nuclear units;14 the position of the elderly in the household has also eroded. Caring for the old parents, unfortunately, has been considered as a burden by many, both physically and economically. Many elders live alone in their homes; a common reason for this is the job-related moves of their children which take them away from home. Most of the young people have to go out of home to other states, even abroad for work. Often parents do not accompany children as they cannot cope with the living away from their home in the old age years, they cannot adapt to the lifestyle and the language elsewhere. Often it is also difficult to adjust to the working routine of their children. So in most situations, elderly parents are left at home in the home state, while children move on. This leads to increased concern for their wellbeing and safety which is shared by both the older persons and their children.13 Safety of the older persons is a major issue these days. Living alone in their homes may be worrisome; so many family members consider that staying in old age homes would be better for the elderly. Besides there is an issue of access to health care; although services are available, accessing them in right time may not be possible by elderly living alone, especially in far away villages. Many factors such as lack of interest, hopelessness and financial hardship, and even physical mobility issues may play a role.12 People consider that old age homes may be better as they will take care of these aspects. Conclusion There should be a process of assessing the possibility of abuse and means to prevent this from happening in the first place. Support systems for the abuse victims should be robust. Old age homes for elderly people should be a later option when other options and care at home are not possible. However to achieve this, proper evaluation of care needs and multi-agency support to address these in the homes and locally are essential. In addition, as a proportion of older people will need care in an old age home setting, there is a felt need for more such facilities in the state, with good quality services. Author information: Namita Rath, PhD. Assistant Professor, Faculty Management Studies, Sri Sri University, Cuttack, India, Email: namita.r@ srisriuniversity.edu.in; Prasanta Kumar Biswal, MVSc, GA 317 Sailashree Vihar, Bhubaneswar, Odisha, India, Email: prasanta.biswal1964@ yahoo.com, Susen Kumar Panda, MVSc, PhD, Professor & Head, Department of Veterinary Pathology, College of Veterinary Science and Animal Husbandry, Orissa University of Agriculture & Technology, Bhubaneswar, 751003, India, Email; drsusen_panda@yahoo.com Correspondence: Dr S. K. Panda, Professor & Head, Department of Veterinary Pathology, College of Veterinary Science and Animal Husbandry Orissa University of Agriculture & Technology, Bhubaneswar, 751003, India, Email; drsusen_panda@yahoo.com Competing interests: The authors have declared that no competing interests exist. Received: 25 May 2017; Revised: 27 June 2017; Accepted: 28 June 2017 Copyright © 2017 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) licence which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Citation: Rath N, Biswal PK, Panda SK. Care facilities for elderly people in Odisha. Journal of Geriatric Care and Research 2017, 4(1): 32-34. References 1. Rath P. Profile of elderly population in India: evidences from Indian censuses. Journal of Geriatric Care and Research, 2016, 3(1): 13-19 2. http://socialjustice.nic.in/writereaddata/UploadFile/Annex ure-X635996104030434742.pdf [Internet] [Cited on 25 May 2017] 3. National Policy for Older Persons. 1999. [Internet] http://socialjustice.nic.in/writereaddata/UploadFile/Nation al%20Policy%20for%20Older%20Persons%20Year%201999. pdf [Cited on 25 May 2017] There is a growing concern of managing the old age related issues in developing states like Odisha. There is a need to provide greater emphasis on this by the government, NGO, including the family and elderly themselves. Financial security in old age is to be looked into and the process should start much earlier in life. Although it may be still difficult for many, available support from government may be explored. Financial independence of the elderly people is an essential aspect as the economic security will also enhance their decision making power in the family. 6. http://socialjustice.nic.in/writereaddata/UploadFile/IPOP% 202016%20pdf%20document.pdf [Internet] [Cited on 25 May 2017] Specific facilities for geriatric health care are needed. These should be available in the community rather than only at tertiary level of health care system. 7. The Status of Elderly in Odisha – 2011. [Internet] http://india.unfpa.org/publications/status-elderly-odisha2011 [Cited on 25 May 2017] 4. http://nsap.nic.in/ [Internet] [Cited on 25 May 2017] 5. Verma R, Khanna P. National Program of Health-Care for the Elderly in India: A Hope for Healthy Ageing. International Journal of Preventive Medicine. 2013;4(10):1103-1107. 33 Journal of Geriatric Care and Research 8. Skirbekk V, James KS. Abuse against elderly in India – The role of education. BMC Public Health 2014, 14:336. http://www.biomedcentral.com/1471-2458/14/336 9. Bhadani KH and Tripathy S. Clash between traditions and economy in geriatric care in India: Observations from a tertiary care hospital. Journal of Geriatric Care and Research 2017, 4(1): 11-12. 10. http://bhubaneswarcuttackpolice.gov.in/senior_citizen_des k.php [Internet] [Cited on 25 May 2017] 11. Rath AA. Clinical concerns of oral health in old age: an Indian perspective. Journal of Geriatric Care and Research 2017, 4(1): 17-21. 34 12. Dey S, Nambiar D, Lakshmi JK, et al. Health of the Elderly in India: Challenges of Access and Affordability. In: National Research Council (US) Panel on Policy Research and Data Needs to Meet the Challenge of Aging in Asia; Smith JP, Majmundar M, editors. Aging in Asia: Findings From New and Emerging Data Initiatives. Washington (DC): National Academies Press (US); 2012. 15. Available from: https://www.ncbi.nlm.nih.gov/books/NBK109208/ 13. Soni D, Manarkattu M, Subbarayan S. The impact of migration on elderly care in developing countries: the hard truth. Journal of Geriatric Care and Research 2014, 1(1): 1113. 14. Chadda RK, Deb KS. Indian family systems, collectivistic society and psychotherapy. Indian Journal of Psychiatry. 2013; 55(Suppl 2):S299-S309.