What is the relevance of Old Age Homes in India?

Many factors have contributed to the alienation of the elders.

• Migration of young couples from the rural areas to cities in search of better employment opportunities to fend for themselves.
• Elders who have been in control of the household for a long time are unwilling to give up the responsiblity to their children.
• Youngsters on their part are sometimes resentful of the attitude of their parents.
• Many youngsters have moved to places far away from their native homes and in the recent past to many countries abroad. So even if they want to they cannot accomodate their parents in their own homes.
• Elders are sometimes too incapaciated or unwell to look after themselves or get medical care especially in an emergency.

All these have made the old age homes seem more relevant in the Indian context than ever before.

What are the types of Old Age Homes in India?

There are two types of Old Age Homes in India.

• One is the "Free" type which cares for the destitute old people who have no one else to care for them. They are given shelter, food, clothing and medical care.
• The second type is the "Paid" home where care is provided for a fee. Nowadays, such "Retirement" homes have become very popular in India and they are well worth considering.

Where should an Old Age Home be located?

An Old Age Home should have a calm, pollution free environment and all other basic necessities just as any comfortable housing project. It could be located in a rural or urban setting depending on the type of people expected to live in it.

While some people may like quiet idyllic surroundings, others may prefer an urban area where they have quick access to facilities in the city.

How should an Old Age Home be designed?

Old Age Homes could be the dormitary type, independent rooms or cottages depending on the social and economic status of those who are going to live in the homes.

The rooms should be well-ventilated.

As much as possible all facilities in the home should be at the ground floor level. If upper floors have to be built then a sloping ramp has to be provided which would also facilitate easy passage of wheel chair when needed.

The toilets and bathrooms should have rough flooring so that the elders do not slip.

Suitable railings should be provided for support.
A room should be set apart where sick people needing short-term treatment could be housed.
Recreation rooms and rooms for medical care should be built.

Who are the people required to work in an Old Age Home?

A home for the aged will need an administrator who will be responsible for the running of the home.

Supporting staff such as clerks, cashier cum accountant, nursing staff, attenders, maids and a cook are the basic required staff for the efficient running of a old age home.

A medical officer will be needed to attend to the health needs of the inmates. If the home is very close to a hospital where emergencies can be treated then, it may be enough to avail the services of a Doctor, who works there part-time.

A nutritionist can play an important role by providing special attention to the nutritional requirements of the residents. At least a part-time nutritionist should be appointed.

A professionally qualified social worker is an essential member of the team of personnel. Wherever possible nursing staff and health care workers trained in Geriatric care should be appointed.

What are the requirements for medical care in such an institution?

All medicines and medical accessories that may be needed for treatment of the residents should be stored as per the advice of a senior physician. For eg: Oxygen cylinders, suction apparatus and intra-venous sets should be readily available.

Drugs should be replaced periodically, considering their expiry date. Transport facilities should be available in case there is a need to rush them to the hospital for intensive care.

What are the other facilities that could be provided in an Old Age Home?

Recreational and reading facilities such as,. televisions, video players, newspapers and books should be available.

Depending on the extent of the physical activity of the residents other facilties for active sports such as: tennis, table tennis, squash can be provided.

Depending on the need billiards and card tables and other entertainment facilities can be provided.

In today's context computers with internet connections are more a necessity than an option especially to receive and send e-mail to the near & dear. The ability to browse the world wide web will allow the residents to be informed and mentally active.

What could be the participation of the residents in the running of the home?

The residents should be encouraged to participate in the day to day activities of the home which may be anything from cooking to maintaining the cleanliness of the home. They could also periodically organise celebrations of various festivals and social events.

Depending on the extent of the physical activity of the residents other facilties for active sports such as: tennis, table tennis, squash can be provided.

United Nation Principles for Older People

To add life to the years that have been added to life, the United Nations General assembly adopted the following Principles for Older Persons on 16th December 1991 (Resolution No.46/91).

• Independence
  • Older Persons should have access to adequate food, water, shelter, clothing and health care through the provision of income, family & community support and self-help.
  • Older persons should have the opportunity to work or to have access to other income-generating opportunities.
  • Older persons should be able to participate in determining when and at what pace withdrawal from the labour force takes place.
  • Older persons should have access to appropriate educational and training programs.
  • Older persons should be able to live in environments that are safe and adaptable to personal preferences and changing capacities.
  • Older persons should be able to reside at home for as long as possible.
• Participation:
  • Older persons should remain integrated in society, participate actively in the formulation and implementation of policies that directly affect their well-being and share their knowledge and skills with younger generations.
  • Older persons should be able to speak and develop opportunities for service to the community and serve as voluteers in positions appropriate to their interests and capabilities.
  • Older persons should be able to form movements or associations of older persons.
• Care:
  • Older persons should benefit from family and community care and protection in accordance with each society's systems or cultural values.
  • Older persons should have access to health care to help them to maintain or regain the optimum level of physical, mental and emotional well-being and to prevent or delay the onset of illness.
  • Older persons should have access to social and legal services to enhance their autonomy, protection and care.
  • Older persons should be able to utilise appropriate levels of institutional care providing protection, rehabilitation and social and mental stimulation in a human and secure environment.
  • Older persons should be able to enjoy human rights and fundamental freedoms when residing in shelter, care or treatment facility, including full respect for their dignity, beliefs, needs and privacy and for the right to make decisions about their care and the quality of their lives.
• Self-Fulfilment:
  • Older persons should be able to pursue opportunities for the full development of their potential.
  • Older persons should have access to the educational, cultural, spiritual and recreational resources of society.
  • Older persons should be able to live in dignity and security and be free of exploitation and physical or mental abuse.
  • Older persons should be treated fairly regardless of age, gender, racial or ethnic background, disability or other status, and valued independently of their economic contribution.

"People are created to give something back to the world. The best way to solve problems is to work together with compassion towards betterment of human life through helping improve the quality of all individuals".

In India, Geriatrics as a speciality has not advanced as much as in developed countries. Infact, until recently, there was no recognised post-graduate M.D. Course in Geriatrics. Recently, the M.D. in Geriatric medicine has been introduced in the Geriatric Department in the Govt. General Hospital in Chennai (Chennai Medical College) India, which has a 20 bedded Geriatric ward. This was first headed by Prof. V.S.Natarajan who obtained his Geriatric training from U.K. It is now headed by Dr. B. Krishnaswamy.

There is also a full fledged department of Geriatric Surgery in the Govt. General Hospital in Chennai, India.

There are other institutions in India where Physicians and Surgeons have taken a great interest in Geriatric health and efforts are on to establish independent departments in Geriatric Medicine and Surgery.

There is also a post graduate diploma in Geriatric health available from Indira Gandhi National Open University (IGNOU).

On this page you will find many links leading to important web-sites concerning Geriatric health and Geriatric societies. We will be providing more links as and when available.

• Geriatric Society of India
• Advancing Geriatric Education and Practice
• Association for Gerontology in Higher Education
• Institute on Aging, University of Pennsylvania
• Publication for Health Professionals
• Multi-Disciplinary Education in Geriatrics and Aging