Healthcare Strategy For Ageing Population
Improvement in healthcare standards have not only contributed to rapid population growth but also increase life expectancy. The percentage of older adults is high and will continue to do so for the foreseeable future. Moreover, the society is changing fast – joint families are being replaced by nuclear family structures and the proportion of working women is also on rise. Are we prepared to allow them to live independently as long as possible is the challenge!! Challenge includes ever increasing number of old age people and most of them with multiple chronic illnesses requiring long term care, stress on family, mental health issues including dementia, disability and the chances of ‘hurt’ or physical ‘injury’. Being ‘frail’ in itself is a condition which merits interventions.
The response needs to be a coordinated effort with multi-layered, multi-sectoral interventions. This would require earmarking budget – but the utmost important thing is development of a strategy from now to cater to this fast emerging need instead of reactive approach much later in time.
Proposed interventions should include, but not be limited to, the following:
(i) Community Geriatric Nursing – introduction of a new cadre with training & capacity building to bring out a network of trained, motivated staff catering to the needs of specialized (particularly placed) care for the aged at their homes or at the community level.
(ii) Mental Health Care especially focused on geriatric psychiatry.
(iii) Day care centres (as opposed to residential old homes) which could provide entertainment and nursing care to elderly when their kids are on jobs and they face extreme loneliness. Such centres can have outreach where a trained Nursing Care practitioner could visit the home for breakfast time medication & cleaning up in morning, lunch time in afternoon and before going to bed needs of elderly around dinner time.
(iv) Fall-Prevention avoidance lessons as well as environment – this may include advocacy messages for the elderly and their family, and measures such as automated staircases etc for the municipal areas frequented by elders per force too – such as banks visited by pensioners and so on.
(v) Chronic-multiple-illnesses management of the elderly with frail bodies. This requires proper medication management viz quality of life, access to free or subsidized medication as in most cases its illnesses with expensive treatments piled up;
(vi) Hospices for the terminally ill (not only for cancer but for all non-communicable diseases) to have pain and comfort management in their last days
(vii) Health promotion strategy towards ‘prevention and wellness across the life span’ – active and healthy life styles from the beginning.
(viii) Any other point.
I understand it is difficult for the Secretariat or Directorate to work on it in isolation due to exclusive expertise required in this particular field – I would therefore suggest consultation with research institutions and practitioners such as Khyber Medical University etc, Health Organizations etc to draw up a draft strategy paper within three weeks time. Dr Shahid Yunis Chief HSRU & Dr Shaheen Afridi, Director DGHS Office shall be the focal point for this.
( Muhammad Abid Majeed )
1. Director General Health Services Khyber Pakhtunkhwa
2. Chief HSRU Health Department
3. Director Public Health DGHS office