Geriatric Health Status in INDIA

INTRODUCTION

Over the period of time population above 60 years has increased in India as well as in the world. Between 2015 and 2030, the number of people in the world aged 60 years or above is projected to grow by 56 per cent, from 901 million to 1.4 billion. The issues pertaining to elderly are different compare to other age groups. Many elders are facing various chronic health and social problems.

Health is very important for everybody. Health is understood as wealth. There will be obstacles always to sustain good health in the absence of disease throughout in our life. Health problems lead elderly to spend money for medical bills and drugs and on the hand their economic status would be declining due to retirement from job and physical and mental deterioration as their problem in their age. Financial security is very crucial for common people to have good health compare to rich people.

As per the Maintenance and Welfare of Parents and Senior Citizens Act, 2007 “Senior Citizen” means any person being a citizen of India, who has attained the age of sixty years or above.

Aging: According to World Health Organization (1994) the term ‘active aging’ defined as “the process of optimizing opportunities for health, participation, and security in order to enhance quality of life as people age” allowing people to “realize their potential for physical, social and mental well-being throughout the life course”.

Why Elderly Population is increasing: India is the second most populated country in the world next to China which has highest number of people in the world. Japan is home to the oldest citizenry in the world, with 27% of its population being 65 years of age or older. The next country is Italy with 23% of its population being 65 years of age or older. In India, Kerala state has highest rate of elderly with 12.6% of its total population. Being Arunachal Pradesh has the least rate of elderly with 4.6% of its total population.

Several forces are driving India’s changing age structure, including an upward trend in life expectancy and falling fertility. An Indian born in 1950 could expect to live for 37 years, whereas today India’s life expectancy at birth has risen to 65 years; by 2050 it is projected to increase to 74 years. Fertility rates in India have declined sharply, from nearly 6 children per woman in 1950 to 2.6 children per woman in 2010. India has also been experiencing a breakdown of the traditional extended family structure; currently, India’s older people are largely cared for privately, but these family networks are coming under stress from a variety of sources (Bloom et al., 2010; Pal, 2007). The demographic change is probably due to the decreasing fertility and mortality rates due to the availability of better health care services (Ingle, G. K., & Nath, A, 2008).

The number of citizens over the age of 60 years has jumped three folds from 7.6 croers in 2001 to 10.3 crore in 2011. The number of Indians over the age of 60 has hit an all time high accounting for 8.6% of country’s 121 crore population. Experts point out that aging economies face the problem of shrinking resources and increasing expenditure. (Zeeshan Shaikh, 2016)

Dimensions of Old Age: Age can be measured in various ways, including the following approaches.

1. Chronological Age: It refers to the actual amount of time a person, has been alive. In other words, the number of days, months or years a person has been alive does not change, regardless of how healthy a lifestyle-even one filled with great exercise and nutrition habitsthey are living.

2. Biological Age: It refers to how old a person seems. It also known as physiological or functional age, biological age because it takes into consideration a number of factors other than just the day we were born. The basic idea behind biological aging is that aging occurs to have gradually accumulate damage to various cells and tissues in the body.

3. Psychological Age: It is how old one feels, acts and behaves and is thus not necessarily equal to chronological age.

4. Social Age: It refers to the changes in a person’s roles and relationships as the person ages.

5. Developmental Age: This developmental approach sees each stage of life as having its own particular and appropriate aspirations and challenges, with none of these being intrinsically ‘better’ than others.

Objectives of the study

1. To understand reasons for increasing aging in India

2. To understand health status of elderly in India

3. To understand role of social worker to minimize issues of elderly

METHODOLOGY

Authors gathered the information by using electronic data based PubMed, EBSCO, MEDLINNE, e-books, text books, inflibnet, and Government annual reports; Help Age reports, website related health, Census of India’s report, Situation Analysis of the Elderly in India, 2011, etc., for the present study. Authors reviewed few original articles and related elderly population.

RESULTS AND DISCUSSION

Both the share and size of elderly population is increasing over time. From 5.6% in 1961, it is projected to rise to 12.4% of population by the year 2026 (Situation Analysis of the Elderly in India, 2011)

Population Census 2011 data reveal that nearly 50 percent of older suffer from Locomotor disability and visual disability. The prevalence of heart diseases among elderly men and women was much higher in urban areas than in rural areas. Urinary problems were more common among aged men while more aged women reported to suffer from problem of joints. Among the elderly persons it is observed that despite illness more men seemed to be feeling that they had a better health condition as compared to the women. In urban areas more elderly men and women felt to have good/ fair health as compared to their counterpart in the rural areas. 

The overall literacy rate among the elderly persons was least (20%) in Arunachal Pradesh. The highest literacy rate was 84% in Mizoram followed by 79% in Kerala and 75% in Chandigarh. The urban literacy rate has been significantly higher than rural literacy rates in all States/UTs. As per the World Bank country wise data; 2011, life expectancy has also increased in India. Compared to life expectancy of 32 years at the time of independence, it was projected to be 65 years for the year 2011.

The above table describes that. Female population is higher 52.8 % in Male population is 51.1% in India.

Life expectancy is higher among female elder population i.e 19.0 per 1000 population.

* The 1981 Census could not be held in Assam owing to disturbed conditions. The population figuresfor 1981 of Assam were worked out by ‘interpolation’.

** The 1991 Census was not held in Jammu & Kashmir. The population figures for 1991 of Jammu &Kashmir were worked out by ‘interpolation’.

*** The figures include the estimated population of Mao Maram, Paomata and Purul sub-divisions of Senapati district of Manipur.

The above graph displays that both male and female elderly population during 1961 was same at 12.4 millions. However, between 1971 to 1991 there was an increase in male population when compared to their counterpart. But from 2001 census onwards there has been striking increase in female elderly population in our country.

Problems of Elderly: It is understood that old age is a normal or natural process. Government of India and other countries have been showing major concern for elderly. Elderly are precious strength of our country, they guide young generation towards building our nation towards strong. Elderly face many problems such as Neuro-psychiatric, physical, social and economic problems. Some of the important problems have been discussed below. death rate (60-64years/Per Thousand) is higher among male elderly population i.e 20.7 per 1000 population.

Neuro-Psychiatric Problems of Elderly in India:

Alzheimer’s disease: Alzheimer’s disease (AD) and other forms dementia are a growing public health problem among the elderly in developing countries, whose aging population is increasing rapidly (Mathuranath, P. S., George, A., Ranjith, N., Justus, S., Kumar, M. S., Menon, R., ... & Verghese, J. 2012).

The study by Mayeux, R., & Stern, Y. (2012) spectate that Alzheimer disease is the most frequent cause of dementia in Western societies. In the US, approximately 5.5 million people are affected, and the prevalence worldwide is estimated to be as high as 24 million. Given that both established and developing nations are rapidly aging, the frequency is expected to double every 20 years until 2040.

Gharal T.K & Roy K, 2017 in their study titled “Alzhemer’s Disease- An Analytical View” stated that there are substantial regional differences in AD incidence within the heterogeneous population of India.

Dementia: The review study titled Indian research on aging and dementia by Shaji, K.S., Jithu, V.P & Jyothi, K.S, 2010) n which they reviewed articles systematically which were published in the Indian Journal of Psychiatry (IJP) from 1958 to 2009 on aging, dementia and other mental health issues of late life. This study shows that there were only a limited number of research articles on dementia in the IJP. Most of the India studies on dementia were published elsewhere. This study highlights that people above the age of 60 years constitute about 5% patients seen in tertiary care settings. And it is important to identify risk factors for depression and dementia in our population.

Stroke: Symptoms of stroke such as dizziness and loss of balance or coordination, sudden trouble seeing in one or both eyes, sudden confusion, trouble speaking or trouble understanding, sudden numbness or weakness of the face, arms or legs, especially on one side of the body. Stroke rehabilitation for the elderly can range from a few weeks to many years, depending on individual’s personal circumstances.

In a study conducted in Gujarat, It was found that modifiable risk factors such as hypertension (40%), alcoholism (35%), smoking (28%) and hyperlipidaemia (17%) are the commonest cause of stroke among the elderly (R. P. Eapen, J. H. Parikh, N. T. Patel, 2009). Further, smoking, alcoholism, increased BMI, diabetes and hypertension are significantly associated with strokes among young people (K, Prasad Kameshwar, & Singhal K.K, 2010).

Parkinson’s disease: Parkinson’s disease (PD) is a common neurodegenerative disorder affecting patients in large numbers throughout the world (Surathi, P., Jhunjhunwala, K., Yadav, R., & Pal, P. K. 2016). The prevalence of PD in India is less compared to other countries (Singhal, B., Lalkaka, J., & Sankhla, C, 2003). the total burden of PD is much higher as a result of large population.

The review study by De Lau, L. M., & Breteler, M. M. 2006 it was reported that an estimated 10 million people in the world (i.e., approximately 0.3% of the world population) and 1% of those above 60 years are found to be affected with PD.

The study conducted by Gourie-Devi, M., Gururaj, G., Satishchandra, P., & Subbakrishna, D. K. 2004) in a door to door survey done at Bangalore district in South Karnataka in India in 2004, the prevalence rate of PD was found to be 33 per 100,000 (crude prevalence) and 76 per 100,000 (age adjusted).

Insomnia in elderly: As per the ICD-10, insomnia is a condition of unsatisfactory quantity and or quality of sleep, which persists for a considerable period of time. As per the International Classification of Sleep Disorders, chronic insomnia is defined as difficulty in initiating or maintaining sleep, despite adequate opportunities to sleep with daytime consequences for 3 months (with a minimum of three times per week (Sateia, M. J. 2014). Many elderly suffer from sleep disturbances due to various etiologies ranging from medical diseases, neurological conditions, psychiatric disorders, primary sleep disorders, psychosocial factors, and environmental factors (Neikrug AB, Ancoli‑,2010 &Rajput V, Bromley SM, 1999).

Only a few elderly visit doctor for sleep difficulties alone, and of which a small proportion could reach or be referred to a psychiatrist or sleep specialist (Leger, D., & Poursain, B., 2005).

Sleep disturbances are often ignored and under-treated during regular medical consultations in the elderly (Benca, R. M. 2005).

A cross-sectional study from Northern India assessed insomnia in 304 elderly men and 200 elderly women attending geriatric clinic reported insomnia is 32% (Gambhir, I. S., Chakrabarti, S. S., Sharma, A. R., & Saran, D. P, 2014).

Arthritis: Arthritis can attack joints in almost any part of the body. Some of arthritis causes changes in vision pain, swelling, warmth, and redness in joints common among these individuals. It is one of the most diseases in this country. Millions of adults and half of all people age 65 and older are troubled by this disease. Most types of arthritis are chronic with symptoms lasting years. Elderly most often have osteoarthritis, rheumatoid arthritis, or gout. Osteoarthritis is the most common type of arthritis in older people. Its symptoms can range from stiffness and mild pain that comes and goes with activities like walking, bending, or stopping to severe joint pain that keeps on even when you rest or try to sleep.

Hypertension: Hypertension is a threat to life at all ages and both sexes, it is one of the leading cardiovascular disorders and important risk factor for coronary artery diseases, cerebrovascular diseases and cardiac failure in elderly patient. Early detection and treatment of hypertension can significantly reduce cardiovascular and cerebrovascular related mortality along with improvement in quality of life (Agarwal, H., Baweja, S. R., Haldiya, K., & Mathur, A, 2005).

The study “Prevalence and factors affecting hypertension among old age population in rural area” (Ankit M. Sheth, Pranay A. Jadav, 2012), in rural area of Vadodara district, Gujarat, India A sample size was 600 from Six Talukas were selected. Results shown that Prevalence of hypertension was 42.7% significantly higher in age group more than 80 years (61%) and females (48%). Hypertension was significantly associated with current alcohol and tobacco consumption. Education, living arrangements, marital status and working status were significantly affecting hypertension (Sheth, A. M., & Jadav, P. A. 2016).

Dental problems: Incidence of oral cancer, which is considered an old age disease, is highest in India, 13.5% of all body cancers are oral cancers. Preventive dental care is almost non-existent to the rural masses and very limited to urban areas. There is no orientation of dental graduates towards the special needs of the geriatric population (Shah N. 2001).

Heart disease: Heart disease is a term covering any disorder of the heart. (Reddy, K. S., Shah, B., Varghese, C., & Ramadoss, A. 2005). Coronary heart disease, arrhythmia and myocardial infarction are some examples of heart disease. Heart disease can be treated with medication or surgery. Quitting smoking and exercising regularly can help prevent heart disease. Cardiovascular diseases (CVDs) have become the leading cause of mortality in India. In Western populations only 23% of CVD deaths occur before the age of 70 years; in India, this number is 52% (Huffman, M. D., Jeemon, P., Prabhakaran, D., Harikrishnan, S., & Leeder, S. 2014).

Cataract: A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery. A cataract can occur in either or both eyes. It cannot spread from one eye to the other. The most common symptoms of a cataract are:

• Cloudy or blurry vision.

• Colors seem faded.

• Glare. Headlights, lamps, or sunlight may appear too bright. A halo may appear around lights.

• Poor night vision.

• Double vision or multiple images in one eye. (This symptom may clear as the cataract gets larger.)

• Frequent prescription changes in your eyeglasses or contact lenses.

Anaemia: Causes of Anemia in the elderly are divided into three broad groups: nutritional deficiency, Anemia of chronic disease (ACD) and unexplained Anemia (UA). These groups are not, however, mutually exclusive. In any given patient, several causes may co-exist and may each contribute independently to the Anemia. The most frequent nutritional Anemia is due to iron deficiency. Anemia of the elderly represents a challenge and a burden for the individual, the community and health care providers. All healthcare providers, should be aware that Anemia impacts a significant group within our societies. It is an entity that lies within our ability to diagnose and treat (Stauder, R., & Thein, S. L. 2014).

Asthma: Asthma is an inflammatory disease of the airways to the lungs. It makes breathing difficult and can make some physical activities difficult or even impossible. Symptoms of asthma; coughing, especially at night, when laughing, or during exercise, wheezing-a whistling sound made when breathing, tightness in the chest, shortness of breath. Asthma is a complex disease that impairs the social, physical, and psychological well-being of the affected (Koul, P. A., & Dhar, R. 2018). Bronchial asthma is the most common chronic respiratory disease, with an case burden approximately 358.2 million in 2015 (CBD, 2015)

Malignancy: It is most familiar as characterization of cancer. Based on the report released by WHO, and International Cancer Research Institute in the year 2012, approximately 14 million new cases were seen in the whole world, while this figure will be expected to rise to 22 million within the next 20 years leading to an increase in the global cancer burden.

Substance use: The major sources of concern among the elderly are use of alcohol, prescription benzodiazepine, and opioids. Elderly substance users have different needs with regard to treatment services, and accessibility issues are among their major concerns (Gage, S., & Melillo, K. D. 2011).

Sarkar S, Parmar A, Chatterjee B 2015 have done review based study on “Substance use disorders in the elderly: A review.” This narrative review aimed to provide an overview of the substance use disorders in the elderly with a focus on the Indian population. This review study revealed that alcohol and prescription drugs are the most commonly found substances of abuse among the elderly. In addition, age-related changes in the elderly associated with medical comorbidities make the use of substances a more problematic issue in this age group.

Smoking: Chatterji and Colleagues (2008) reported a high rate of smoking (26%) and inadequate physical activity (18%) among Indians. These behaviours will likely translate into further ill health. In addition, Almost one-half (47%) of older Indians have at least one chronic disease such as asthma, angina, arthritis, depression, or diabetes.

Cognition and bipolar disorder in the elderly: Late-onset bipolar disorder has been widely reported to be associated with cognitive impairment and this association is more strongly associated with severe cognitive impairment as compared to an early-onset bipolar disorder (Eastham JH, Jeste DV, Young RC.1998 & Aprahamian I, Ladeira RB, Diniz BS, Forlenza OV, Nunes PV.2014)

Suicidality in Elderly Depression: Surprisingly there is lack of research on suicidal behaviour in elderly patients with depression. A study reported that suicidality in elderly patients with depression was strongly associated with impulsivity and hopelessness (Trivedi, S. C et all, 2014). Despite the life expectancy and the facilities that medical and social systems provide to elderly, they experience problems like loneliness; depression etc (Thomopoulou, I., Thomopoulou, D., & Koutsouki, D. 2010). Suicidal ideas can be found in Sever Depressive Disorder cases.

Psychological Problems: The common psychological problems of elderly are: feeling of weakness, feeling of inferiority, incompetence or helplessness, feeling of isolation and reduced capability. With growing age, elders experience many anatomical and psychological changes. These variations bring several psychological, behavioural and attitudinal changes in elderly. Population aging also generates variety of social and health problems, among which of special concerns are the problems related to psychological well-being of elderly (Lim, L. L., & Kua, E. H. 2011).

Social problems: In view of sociologically, aging indicates moving one set of social roles to other roles which are challenging due to recent changes in in the field of education, technology and urbanization. Definitely, elder render their experience of knowledge to younger generation. But, once they retire, they find that their children are not taking guidance. Because of this, elderly face problems such as feeling of loss in terms of their status at home, insignificance and isolation. If elderly are financially depended on their children, the problem becomes more. Older people suffer social losses prominently with age. Their social life is constricted down by loss of work associated, death of relatives, friends and spouse and weak health which restricts their participation in social activities. The home becomes the centre of their social life which gets confined to the interpersonal relationship with the family members. Due to loss of most of the social roles they once performed, they are likely to be lonely and isolated severe chronic health problem enable them to become socially isolated which results in loneliness and depression, (Prasad R, 2017).

Loneliness: Loneliness has been described as a complex set of feelings that occurs when intimate and social needs are not adequately met and that drives individuals to seek the fulfilment of these needs (Cacioppo JT, Hawkley LC, Ernst JM, Burleson M, Berntson GG, Nouriani B, et al.2006)

Old age is often seen to be marked by loneliness. Studies have shown that loneliness is linked to depression, lower quality of life and increased vulnerability to both physical and mental health problems of the elderly (Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. 2006).

Elder Abuse: The World Health Organization (WHO) describes elder abuse as “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.” Studies from India have reported a prevalence rate of about 14% (Dong XQ, 2015).

A recent study from Bengaluru, Karnataka, India evaluated 200 elderly patients attending a medical college. According to this study, about one-third of the elderly reported facing abuse or neglect in the form of either verbal abuse, neglect, financial abuse, or physical abuse. There was a statistically significant association between elder abuse and total financial dependence, lack of social support, and depression among the elderly patients Nisha, C., Manjaly, S., Kiran, P., Mathew, B., & Kasturi, A. 2016).

There is some evidence to suggest that there is a trend to shy away from the traditional role and responsibility of caring for the elderly and data suggest that the elderly often face abuse, neglect, and violence. Studies over the years from India have shown that many a time emotional, financial, health, and social needs of elderly subjects are not met and as a result, they have feelings of being abandoned, neglected, maltreated, threatened, exploited, and emotionally blackmailed (Shankardass, M. K, 2008).

Economic Problems: Financial uncertainty is one of the important problems among elderly. Women 60 years and above face many disadvantages such as difficulties to access basic needs such as food, medicine, housing etc. Elderly people face several challenges and one of the most important among those is the problem of financial insecurity. Many surveys have shown that even retired elderly people are confronted with the problems of financial insecurity and loneliness (Prasad R, 2017).

Living in Old Age Homes and Housing Problems: Akbar, S., Tiwari, S. C., Tripathi, R. K., Kumar, A., & Pandey, N. M. 2014). have conducted a study on “Factors Compelling Elderly to Reside in Old Age Homes (OAHs). The object of this study was to explore the factors compelling elderly to reside in old age homes. This study was carried out on 174 elderly residing in 14 different OAHs of Uttar Pradesh, India. Factors responsible for their settlement in OAHs were explored using interview method. Results shown that Misbehaviour of son and daughters-in-law (29.8%) was found to be most common reasons for residing in old age home. Poverty/ no financial support, to serve the almighty God, loneliness, adjustment problem, nuclear family system, having no son, settlement of children at abroad. Children do not want to keep the elderly with them due to psychiatric and/or physical illness, life threats from children. Desire to live independently/ unable to tolerate interference of family members. Many Elderly are facing housing problems due to financial constraints.

Some social challenges to elderly care:

Lack of Infrastructure: With increasing longevity and debilitating chronic diseases, many elder citizens will need better access to physical infrastructure in the coming years. Lack of physical infrastructure is a major deterrent to providing comfort to the aged. Many elder citizens need better access to physical infrastructure, both in their own homes and in public spaces.

Lack of social support: The elderly in India are more vulnerable because of the less government spending on social security system. The elderly in urban area rely primarily on hired domestic help to meet their basic needs in an increasingly-chaotic and crowded city. Social isolation and loneliness has increased (Rajan, S. I. 2006).

In a study by Lena et al., 2009 almost half of the respondents felt neglected and sad and felt that people had an indifferent attitude towards the elderly. It was also found that 47% felt unhappy in life and 36.2% felt they were a burden to the family.

Social inequality: Elderly are a heterogeneous section with an urban and rural divide. They are less vulnerable in rural areas as compared to their urban counterparts, due to the still holding values of the joint family system. All the elderly are not seen in the same view as the needs and problems of elderly are rejected to a vast extent as government classifies the people based on caste and other socio cultural dimensions.

Availability or accessibility and affordability of health care: As pointed by Dey et al., 2012 the key challenges to access and affordability for elderly population include reduced mobility, social and structural barriers, wage loss, familial dependencies, and declining social engagement. The stigma of aging is another social barrier to access of health in addition to the health and social conditions the elderly commonly face such as dementia, depression, incontinence and widowhood.

Economic dependency: As per the 52nd round of National Sample Survey Organization, nearly half of the elderly are fully dependent on others, while another 20 percent are partially dependent for their economic needs. About 85% of the aged had to depend on others for their day to day maintenance. The situation was even worse for elderly females. Elderly often do not have financial protection such as sufficient pension and other form of social security in India. The single most pressing challenge to the welfare of person is poverty, which is a multiplier of risk for abuse.

The key challenges to access to health for the Indian elderly include social barriers shaped by gender and other axes of social in-equality (religion, caste, socio economic status, and stigma). Physical barriers include reduced mobility, declining social engagement, and the limited reach of the health sys-tem. Health affordability constraints include limitations in in-come, employment, and assets, as well as the limitations of financial protection offered for health expenditures in the Indian health system (Dey, S., Nambiar, D., Lakshmi, J., Sheikh, K., Reddy, K., Smith, J. P., & Majmundar, M. (2012). Also, factors such as a lack of transport facilities and dependency on somebody to accompany an elderly person to the health care facility impede them from accessing the available health services (Ingle, G. K., & Nath, A. (2008).

Legislative Provisions for Elderly: The Maintenance and Welfare of Parents and Senior Citizens Act, 2007 was enacted in December 2007, to ensure need based maintenance of parents and senior citizens and their welfare.

National Policy on Senior Citizens 2011: The National Policy on Older Persons was announced by the Government of India in the year 1999. It was a step in the right direction in pursuance of the UN General Assembly Resolution 47/5 to observe 1999 as International Year of Older Persons and in keeping with the assurances to older persons contained in the Constitution.

Schemes and Programmes for Elderly in India:

1. The National Social Assistance Programme (NSAP)

2. “National Programme for the Health Care of Elderly” (NPHCE)

3. Other provisions: The Ministry of Social Justice and Empowerment coordinates programmes to be undertaken by other Ministries in their relevant areas of support to older persons. Pensions, travel concessions, income tax relief, medical benefit, extra interest on savings, security of older persons through an integrated scheme of the Ministry of Social Justice and Empowerment as well as financial support was provided for Homes, Day Care Centres, Medical Vans, Help Lines etc are extended currently.

ROLE OF GERIATRIC NURSE PRACTITIONER (GNP)

Gerontological nurse practitioners are responsible for monitoring chronic health problems such as dementia, high blood pressure, diabetes, arthritis and debilitating illnesses like Alzheimer’s Disease. A major responsibility of geriatric nurse practitioners is prescribing medications and collaborating closely with physicians and all other health care professionals to provide continuity of healthcare.

But the role of GNPs is not solely confined to physical health care. You are also an educator, responsible for providing incentives, direction and educational material to help the patients learn about their own particular illnesses and how to best take care of themselves.

Geriatric nurse practitioners take into consideration the special learning needs of each client and often implement self-paced learning modules using visual aids and audio-visual methods. The role of healthcare education for the elderly also extends to their families and GNPs are regularly called upon to inform and educate the patient’s family, community and colleagues about their particular requirements to help improve their quality of life.

Geriatric nurse practitioners are important advocates for overseeing the appropriate utilization of healthcare resources geared to the needs of elderly people. They also provide essential educational services to older clients, their families and other nursing and medical professionals involved in their care.

Today, many GNPs are innovators in the field of geriatric nursing and age-related healthcare and initiate or collaborate in research aimed at improving the lives and long-term care of their patients. Gerontological nurse practitioners are fulfilling an important role in our aging societies.

Hundreds of millions of Indians are now in the seniors age bracket of 50 years+ and over the next three decades this is going to place a tremendous strain on healthcare in the India. Geriatric nurse practitioners are on the front-line of geriatric healthcare and most of these nurses are needed to provide the specialized care for our rapidly aging society.

If you are looking for a care in nursing that is becoming highly sought-after with each passing year, training to become one of today’s desperately needed gerontological nurse practitioners could be just the role you have in mind.

Conclusion: Health problems can be prevented and controlled through change in life style, understanding nature of illness, compliance to medication. Further, practice of meditation, yoga, and seeking guidance from health professionals when elderly not able to handle their disease may help them to lead counted life. The role of Government, NGO’s and other association which are providing health social services to elderly play an important role to prevent health diseases and promotion of good health. There is a need to have better living conditions, better security measures, and affordable health facilities including Geriatric rehabilitation centres and free mental health facilities for the elderly in the society.