Home / News / India /  'Building a robust ecosystem for seniors is the need of the hour'

New Delhi: The elderly, who are the most vulnerable to the covid-19 pandemic, are devoid of easy access to healthcare and rehabilitation services in India. Nanki Lakhwinder Singh, chief executive officer and managing director at Genesis Rehabilitation Services India (GRSI) that provides senior home healthcare across India during the pandemic, talks about the situation faced by this fast-increasing population in India, status of rehabilitation services for them and way forward. Edited excerpts from an interview:

What is the effect of the pandemic on the geriatric population?

Covid-19 not only made them vulnerable physically but also emotionally. Older adults have a weak immune system and are more likely to already have comorbidities which increase the risk of severe covid-19 and infection-related death. The pandemic put the elderly under house arrest-like living situations, encapsulating them within the walls of their homes, restricting their movement outside, and even halting or delaying their health checkups. Social isolation and loneliness increase older people's risk of anxiety, depression, cognitive dysfunction, heart disease, and mortality.

Is India equipped to deal with the increasing elderly population in the country?

India is surely witnessing a demographic shift. The elder population in India has witnessed a firm rise in the last few decades. The projections indicate the number of 60+ will surge to 143 million in 2021 and 173 million in 2026 amounting to over 10% and 12% of the estimated total population respectively. A report by CII projects that India’s senior population will increase threefold to 300 million by 2050. While these are verified statistics, what is important to understand is that India is not ready to deal with these numbers. There are minimal services to care for the needs of this growing population. There is barely any government regulation, quality control or any insurance. We must work towards a solid infrastructure to ensure a healthy and happy senior population. The Nuclearization of families along with an increase in life expectancy, economic dependency especially for women, and greater dependency of elders on others for day-to-day assistance are big challenges for Seniors. There is not enough structured support today to assist seniors as they age. Their fragility makes them vulnerable and become dependent on their caregivers for every small activity, they often suffer neglect, mistreatment, and abuse.

Do you think sub-acute structured care for seniors is being considered as an option for issues other than acute care?

Sub-acute care is now beginning to be understood as not just a lifestyle choice but important for overall health and well-being. The trend of nuclear families in the past few years has led to seniors understanding the importance of being independent and self-sufficient, hence considering structured care and other amenities to support them physically and emotionally is becoming high priority. Even if living in a joint family, the elderly usually is the neglected section of society and face social issues with loneliness, elder abuse, and poor access to health care. Structured systems such as home care, adult interactive social set ups (adult day programs), and sub acute set ups like long term care, Memory care centres and assisted living programs provide a unique opportunity and potential to connect with aging adults and guide care beyond their hospital stay for true healthy living and aging.

Do you think the elderly have been benefitted from the TeleWellness programs?

The pandemic has ushered in a new era of TeleWellness providing a better and safer option for the elderly to seek medical advice. Virtual care can provide a lot of comfort and fulfil a lot of sub-acute care needs. GRSI has also launched its TeleWellness program which is really “phydigital" that is it is virtual supported by physical home care through our partners with an aim to create an easily accessible and responsive elder care support system within a technology enabled ecosystem. The program itself a continued care program that goes beyond acute needs. Home care, tele consultation, holistic living and sub-acute care management are key components of the program. In covid period digital health can be a key enabler in building an easily accessible support system for the well-being of seniors. As India witnesses a surge in the positive covid 19 cases, GRSI has come up with a covid care package to provide at home covid care.

How can the government support senior citizens to create a robust healthcare ecosystem for senior citizens?

To create a robust healthcare ecosystem for senior citizens, government support is very crucial. It must go beyond acute care. A good robust sub-acute care system not only eases the burden on more expensive resources but also enables good and healthy aging. The pandemic made us realize that in India it is necessary to introduce measures to bring in increased investments and resources into senior care, enhance the quality of health services, make it easily accessible to all and improve emergency preparedness. Building a robust ecosystem for seniors is the need of the hour. Affordable and accessible care for seniors must be given its importance and place in the national policy framework. This framework must be all encompassing from acute care to mental, emotional, physical and sub-acute care to enable a senior to live their life to the fullest. The push is also needed with regards to rational and promotional policies for all the stakeholders.

Will an increased budget outlay for healthcare, especially senior care, improve the senior care ecosystem in India?

In the Union Budget 2021, the government has announced important measures to prioritize health for all citizens. The six pillars on which the 2021 budget rests, begin with health and well-being, as the first, followed by infrastructure, inclusive development, human capital, innovation/ R&D, and good governance will help build a healthy society and address foundational gaps in the healthcare systems. An increased budget outlay for healthcare will help develop the healthcare infrastructure, scale up vocational skills training of allied health workers, and introduce reform in the senior care space to improve the quality of life. The higher financing would surely help in improving the senior care ecosystem directly and indirectly.

What is your take on the Draft National Policy for Senior Citizens 2020?

Last year the Ministry of Social Justice and Empowerment came out with a draft National Policy for Senior Citizen 2020. It aims to create a more vibrant senior care ecosystem. The Ministry sought suggestions from key stakeholders in June 2020. I am a governing council member of the Healthcare Federation of India (NATHEALTH) and spearhead its dedicated senior and rehabilitation vertical. Hence on this platform, we collated views of private players. We have given our feedback and suggestions on every aspect of senior care including financial security, health insurance, shelter for senior citizens, rehab care, re-skilling and employment, intergenerational bonding, capacity building, dedicated agency, accountability, and focus on securing senior women citizens among others. Moreover, we have prepared a white paper and that would give a clear roadmap for creating a robust elder care ecosystem. Hence, we have also requested the government to incorporate those suggestions before implementing the policy. I also strongly recommend that there is a need for Silver economy promotion to increase liquidity, low-cost funding, preferred status with regards to land allocation, single-window approval, tax exemptions for senior care service.

Do you think the silver economy is a potential driver for India’s growth?

There is a need for silver economy promotion and it would help in making senior care both economically viable and an opportunity for economic development. Covering the needs and demands of seniors, the silver economy would cover many products and services using very different technologies, including home automation, sensors, and connected objects. With a viable model, states can allocate land and funds to build capacity to take care of seniors, including those from the weaker sections. Moreover, the elders should be encouraged to make some items for trades like handicrafts or even some savouries for sale through their unions. The silver economy would provide financial security, livelihood and income generation, shelter, skilling and re-skilling, health care and nutrition, awareness, and capacity-building. It would increase liquidity and low-cost funding with regards to land allocation, single-window approval, tax exemptions for senior care service. It is also a fact that silver economy promotion would require huge investment. Hence, the public-private partnership would be the most viable model.

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