An Age Friendly Initiative: Active Ageing Non-institutional Services To Older Persons In Urban And Semi Urban Communities Of India

Dr. Alakananda BanerjeePresident

Dharma Foundation of IndiaChairman Health committee All India Senior

Citizen Confederation

Projected to be 113 million, i.e. 8.9% of total populations by the year 2016

Arthritis Respiratory Care Cancer Cardiovascular Vision/Cataract Bladder and bowel dysfunction Neurological deficits

Elder abuse Social Isolation Financial Lack opportunities for re employment Unawareness of rights of elders.

“Attainment of Universal Access to Equitable, Affordable and Quality health care services, accountable and responsive to elderly needs, with effective inter-sectoral convergent action to address the wider social determinants of health”.

Constitute government and private sector having primary, secondary and tertiary healthcare facilities.

The various problems faced by the healthcare industry are shortage of doctors, nurses and infrastructures leading to unavailability of cost effective and accessible care at the primary level.

Missing

Health Systems in India

NGO/Trust/SCWO

Private Hospital

Semi-Govt (Public)Hospital Govt. Hospital

Curative care Preventive care

Suggested Preventive Program

Corporate Companies/government sector employees

Absence of government

policies

Community Care Centre(CCC)

Allied Health ProfessionalsSugarObesityPainBlood pressureDementia

Preventive and early detection

Curative Follow up Rehabilitation/

Chronic Care

04/18/23Towards Building an Age Friendly

Community 9

Participation of older persons in finding solutions

•Old age home•Assisted living•Age in place

Formulated on international research and knowledge based on important principles and guidelines by WHO Active Ageing Policy and Towards Building an Age Friendly City.

COMMUNITY CARE CENTRE (CCC) SOCIAL, PHYSICAL AND MENTAL HEALTH OF OLDER PERSONS IN

URBAN AND SEMI URBAN INDIA

Voluntary Elders-Coordinator of CCC-Emergency Healthcare Duties-Workshop scheduling

Ageing in Place

Age Friendly Initiative of Dharma Foundation of India (DFI)

Allied Health Professionals• informing and encouraging people to stay healthy and prevent illness(Prevention)• Early Detecting health conditions• Having the capacity to treat disease (Curative)•helping patients with rehabilitation (Chronic/long term care)

Managed by

Education/Empowerment-27 workshops on health and social issues- Distribution of booklets

Groups formation-Selection of voluntary elder members as a group leader/local supervisor-10-15 elder in a group

Integration of community care and hospital services through CCC - Small space allocated by Senior Citizen Organization (SCO)-Neighborhood hospitals

Technology for active ageing- mHealth- Point of Care Testing

MODEL FOR ELDERLY IN INDIA

Empower and create opportunities for community dwelling older persons to participate in their health and social issues.

Develop health and social models.

Address the fragmented health and long-term care system in India to adopt care models

Publish research/evidence based data to help State Governments and Central government of India to framework future policies for older persons.

To help the elders of the area to avail basic health facility the local SCWO will run a CCC in a small space allocated by SCWO.

The center will be managed by active elder members of SCWO. A trained (graduate or post graduate physiotherapist) will work for 4 hours in the CCC.

There will be basic equipments for physiotherapy pain relief modalities, and mobility aids. Equipments to measure blood pressure, blood glucose, and nebulizers will be available in the clinic.

The nutritionist will visit the community elders twice a month to assess nutritional uptake and guide diet taken by elders.

•80 elder women members , Target disease: joint pain ,hypertension

Exercises

Home to home

Diet Counselling

Nutritional Assessment

04/18/23Towards Building an Age Friendly

Community 18

• Activity: • Workshops for education/empowerment

of elders•

27 awareness programs/ workshops (once a week)

• These workshops are taken by healthcare providers, sociologists, lawyers and lawmakers

Activity: Distribution of booklets

Briefs of these lectures are translated in local languages and distributed as booklets to the elderly who attend the workshops

Physiotherapy Staff

The Physiotherapy Staff shall run physiotherapy services in CCC from 10am to 1pm.

The Physiotherapy Staff and SCO have the right to complete confidentiality and will not share any information of subject/patient of in any forum.

The Physiotherapy Staff shall be responsible for equipment /inventory and maintain ace of equipments .Registers shall be maintained for the same.

The Physiotherapy Staff shall follow SOP for equipment and treatment given

The Physiotherapy Staff shall visit home of older person as part of campaign and projects of SCO.

The Physiotherapy Staff shall take workshops/awareness programs/caregiver education of older persons.

The Physiotherapy Staff shall supervise older persons needing long term care.

Voluntary Older Member

8 members of the SCWO shall take up services pertaining to the following duties

(posted for 3 months) 2- Running of CCC 10am to 6 pm (4 hours

daily) 2- Emergency Healthcare Duties (member

should own and able to drive a car confidently)

2-Hold Education Workshop pertaining to social laws/advocacy, distribution of handouts to all members regarding Rights of Elders, available 10am to 6 pm on phone to take calls and guide and answer queries.

2 –Working Committee Members

Around 10-15 elders can avail this service every day.

The Community Therapist shall also do one on one home visits to screen health, social and mental issues and supervise elders who need long term care.

• Elder Groups:• Small groups of 10-15 elder subjects shall

be made.

• Selection of voluntary elder members as a group leader/local supervisor.

• Social interaction will be encouraged in smaller groups where group leader conduct exercises/recreational activities/discussions

Nonmedical interventions can assist elders in coping with and adapting to changes as one ages.

Health and social services delivered within a neighbourhood by local people in local establishments, and community-based support and voluntary groups can play an important role in delivering support and care to older persons.

The Self-Management and Community Wellness Program will not conflict with existing programs or treatment as it is designed to enhance regular treatment and disease-specific education given by clinicians/family physicians in healthcare organization.

• Inputs of group meetings will be discussed carefully documented and presented to the local government representative.

• Encourage active participation of the elders in voicing their opinion regarding community problems

• It may form a cost effective way to introduce prevention/early detection of co morbidities in elders.

Community Care Centers may work as small hubs where information about elder rights, government policies, social issues, environment concerns may be shared with elders.

Interventions of group activities and self managing co-morbities have improved mobility and quality of life of elders in the community

There is more awareness about government services and policies available to older persons.

The Community Physiotherapist is a friendly healthcare provider, approachable and accessible.

The Community Physiotherapist is a known face in the neighbourhood. A small fee of Rs 30/-is paid by elders for consulting her/him and the nutritionist.

The older persons prefer the services as they can walk to the clinic which is accessible to those staying nearby.

Manpower Costs:Physiotherapy payout per month: Rs 4000Voluntary Older Person : Gift for Rs 500 (on

completion of 3 months)Stationary: Rs 1000/monthEquipment and stationary costs:Equipment and furniture: Rs 1,00000 (one time

cost)Booklets in Hindi and English;Rs50,000 (for 1000

booklets) 

Physiotherapy per session at CCC: Rs 50 Physiotherapy Package for 10 sessions at

CCC: Rs 400 Physiotherapy per home session: Rs 200 Physiotherapy Package for 10 home

sessions: Rs 1800 Booklets: Rs 20

DFI has been involved in research and development with following international

collaborators where the model has been developed with WHO-

SEARO

Our International Collaborators

Dr Anirban Dutta-INRIA France Dr Subhasis Banerjee: NTU Singapore

Dr Pradeep Ray: APuHC Sydney Australia