Geriatric Medicine specilisation needed in India

India is gradually undergoing a demographic change. With decline in fertility and mortality rates accompanied by an improvement in child survival and increased life expectancy, a significant feature of demographic change is the progressive increase in the number of elderly persons.

According to UN by 2050, nearly 20% of India’s population will comprise of people over the age of 60 years. According to UN India will soon surpass 10% aged population which will make India a Ageing nation.

Presently India has 2^nd largest number of Elderly. In 2009 India's population of Elderly i.e. 60 + is estimated at around 8% of total population which is around 90 million.

Health related issues are one of the major challenge for government and civil society for care of the growing population of Elderly.

Government should Include Geriatric care component under the syllabi of medical and nursing courses.

Medical Council of India should start specialization master / bachelor degree for Geriatric / Geriatric medicine.

Geriatric should also be a part of the curriculum for all the students in medical colleges. Medical colleges should be persuaded to introduce such courses for students at all levels.

Throughout the 21st century health professionals will increasingly be required to be familiar with old age care whatever the specialty they choose.

Identifying the areas of research related to geriatric diseases such as Alzheimer’s disease, dementia, psychiatric, respiratory, cardiovascular, physical disability etc. is very important to get ready for Elder tsunami.

WHO has recommended following basic contents for Undergraduate Medical Teaching in Geriatric Medicine:

1. Understand the biology of ageing and its relationship to the clinical manifestations of diseases in older individuals. Older patients manifest signs and symptoms of disease because they are sick, not because they are old.
2. Demonstrate appropriate knowledge of physiology of ageing to understand concepts such as frailty and loss of functional capacity.
3. Demonstrate knowledge of the demography of ageing.
4. Demonstrate sufficient knowledge of pharmacology in order to understand basic principles of prescribing for older people, with special attention to adverse effects and iatrogenic disease. This includes not only knowing what to prescribe but also when drugs should be withdrawn, and the risks of polypharmacy.
5. Recognize the role of psychosocial risk factors, such as living alone, economic hardship and lack of social support, in the causation and experience of disease.
6. Recognize the importance of providing support to family caregivers who, themselves, may be old and in poor health.
7. Recognize prevention and rehabilitation as the main goals of Geriatric Medicine.
8. Understand that the optimisation of health in frail older people or those with disabilities requires multi-dimensional evaluation and multidisciplinary approaches for the attainment of better outcomes.
9. Consider a problem-oriented approach as the most appropriate in the care of older people.
10. Embrace a holistic perspective, understanding that older persons have a rich history behind them and embrace life-course events as the root of many of their current ill-health conditions.
11. Understand that a life course perspective also implies that today's children and younger adults are tomorrow's older people and that their health in older age depends on how they live.
12. Be familiar with the management of the great geriatric syndromes - such as falls, incontinence and cognitive impairment - as well as with conditions highly prevalent such as depression and the subtle presentation of disease in old patients.
13. Demonstrate positive attitudes to ageing, speaking out against negative stereotypes.
14. Recognize the distinct aspects of abuse against older person.
15. Recognize ethical issues including end of life care.

Hope Government of India and Medical Council of India will wake up now to provide dignified health and medical services to the Senior Citizens of India.

Silver Inning Foundation supports all such initiative for the cause of Elderly.