Policy makers challenged by ageing population

23 October 2013 06:42 pm - 1     - {{hitsCtrl.values.hits}}


Unlike in the 19th century the biggest demographic scare of this age is not the increasing population and the decreasing food resources. Although scarcity of food resources continues to remain a threat, the boom of the ageing population seemed to have gripped the policy makers, demographers and sociologists with concern  as the life expectancy rates are increasing while the birth rates are falling not only in “rich’ countries but also in emerging countries.

The “greying of the globe” will eventually become a challenge to every nation and with the rising geriatric population countries need to be prepared to provide the required medical, social as well as emotional support to the growing elderly population. Dr. Anula Wijesundara, a consultant physician at the Sri Jayewardenepura Hospital spoke about these challenges that Sri Lanka should tackle especially with concern to providing medical care for those above 65 years. With years of research in London about geriatric care and her wealth of experience as a physician in Sri Lanka Dr. Wijesundara shared her views about medical needs and the social support that have to be rendered to the rising ageing population.

“Caring for our elders is very important because it addresses the basics of humanity. It’s the way we can show our gratitude to the generation that was instrumental in raising the current working population. Actually ageing should be perceived as an achievement because a person has survived all the hardships of life” pointed out Dr. Wijesundara emphasising on the importance of focusing on geriatric care.

Elderly population in Sri Lanka
According to Dr. Jayasundara not just the developed countries, even rising nations face the challenges that arise with rising geriatric population. In Sri Lanka the rise of the population above 65 years of age will be 200% by 2050. Referring to the statistics from the Population Pyramids of the World she pointed out that in year 2000 the aged population’s rise was only 9% and added there is a marked increase in the Sri Lankan ageing population while the overall population rise has not experienced such a growth. She noted that among the Asian countries Sri Lanka stands as the 5th country to have the highest number of geriatric citizens and added that the health care system should be focused on addressing the needs of the geriatric as even now about 90% of the medical beds in state hospitals are occupied by patients over 65 years except during an epidemic of dengue.

An integrated health care system
“Our physicians in Sri Lanka have done a fantastic job in treating the geriatric even though our country does not have a separate discipline or wards to treat the geriatric. It is also important to stress upon the need to have an integrated health care system where specialised units for geriatrics will function with geriatricians and other professionals such as physiotherapists, occupational and speech therapists, social workers, nurses and care givers” she said.

Currently, Sri Lanka does not posses separate units in any hospitals to treat the elderly. Dr. Wijesundara said, in the United States there are about 7000 geriatricians which means, to a population of 10,000 there are 3.8 geriatricians. However since Sri Lanka only recently introduced a post graduate diploma on geriatric medicine, currently there are no geriatricians in Sri Lanka. While Dr. Wijesundara said the situation will change overtime, as there is increased concern and interest over this area of medicine, she said the integrated system should not focus solely on producing geriatricians.

Minimal drugs and early diagnosis important
The diseases suffered by the elderly are often difficult to diagnose when compared to a person who is young, as the symptoms of a disease do not manifest very clearly in the case of a person who is above 65 years of age.

“If an elderly person is experiencing cardiac arrest he will most probably get a mild chest pain whereas in a young person it is very easy to detect because the chest pain is severe. This is just a simple example, but usually early diagnosis is important as the symptoms manifest mildly or maybe delayed, and treating the disease earlier will reduce the risk posed to the patient’s life” said Dr. Wijesundara.

She also emphasised that the number of drugs prescribed to the geriatric should be kept to a minimal, as treating one disease with several drugs would complicate the symptoms leading into late diagnosis causing considerable risk to the patient’s life.

Dr. Wijesundara said, conditions such as Alzheimer’s, Dementia and Parkinson’s disease should be given special focus, as patients who have these conditions require regular and undivided attention of care-givers to lead an emotionally and physically healthy life.

“There are about 120,000 Dementia patients in Sri Lanka and they have to be looked after through day-care, care-giving and patient education facilities. For Alzheimer patients in Sri Lanka there is a foundation which is called Lanka Alzheimer’s Foundation at Ketawalamulla Lane in Maradana, and it provides free services such as memory testing to help patients. More such organisations should be established to create a social support system in Sri Lanka,” she said.

Family Environment is the best
Commenting on the social and familial support elders should be provided with, Dr. Jayasundara was of the view that placing elders in their family environment is the ideal way to take care of them.

“Though there are special homes for elders, still in Sri Lanka children make it their responsibility to look after their elderly parents in almost all the families. With busy life-styles and economic hardships this could be a challenge, but the ideal environment for a geriatric is his or her home or family environment. In Asian countries the concept of extended families have helped the elderly and the young generation and we should continue this tradition,” she said.

“Some elderly people adjust well when they are in elders’ homes as they are with people who are in the same generation, but in most cases the elderly feel depressed and isolated when they are removed from their family, so the best choice is to provide the geriatric with love and affection in their family environment,”

Dr. Wijesundara said.

  Comments - 1

  • antonsunil Thursday, 24 October 2013 05:19 PM

    Yes it has become a world phenomena. these are the signals of extinction of mankind.

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