Relevance: GS-II Health, Welfare Schemes for Vulnerable Sections of the population
Mains Take away: Ageing India & TB
Why In News:
Recognizing the International Day of Older Persons on October 1 is an opportunity to raise awareness about the challenges and opportunities associated with an aging population. As people age, they may face specific healthcare challenges. Conditions like tuberculosis (TB) can have a more significant impact on the elderly due to age-related changes in the immune system. Addressing these health needs is crucial.
How TB impacts the elderly
- Delay in Diagnosis: Symptoms of TB (e.g., cough, fatigue, weight loss) are often mistaken for signs of other diseases or dismissed as signs of old age, leading to delayed or missed TB diagnoses among the elderly.
- Comorbidities: Management of TB among the elderly is complicated by multiple comorbidities, especially diabetes, resulting in a higher pill count and an increased likelihood of side effects.
- Treatment Adherence: Multiple comorbidities can lead to irregular treatment adherence and poor outcomes, including death. Some elderly individuals with TB may lose their "will to live" due to lack of social and emotional support.
- Access to Healthcare: Older individuals, particularly women, face challenges in accessing health services, especially in rural and hilly areas where traveling to health facilities can be difficult.
- Limited Information: Elderly individuals have limited access to reliable health information as their social networks tend to shrink with age.
- Infrastructure-Related Challenges: Infrastructure issues, such as lack of adequate seating in healthcare facilities, can make it difficult for older persons to seek care.
- Infrastructure-Related Challenges: Infrastructure issues, such as lack of adequate seating in healthcare facilities, can make it difficult for older persons to seek care.
- Nutrition: Many older persons do not have access to high-quality nutritious food, which is critical for recovery from TB.
- Economic Dependence: Most individuals over the age of 60 are no longer working and may be dependent on savings or family support, leading to economic challenges.
- Limited Social Welfare Schemes: Social welfare schemes for the elderly are limited in scope and can be difficult to access.
- Ageism and Stigma: Ageism, recognized by the World Health Organization, contributes to poor health and social isolation among the elderly, who may experience mental health challenges, loneliness, and anxiety about not being seen as "useful."
Building age responsive care
- Holistic Care Models: Shift from disease-specific, vertical care programs to holistic care models that reduce the need for elderly individuals to interact with multiple healthcare providers and facilities. • Integrate TB care with the management of other comorbidities commonly seen in the elderly.
- Capacity Building: Provide training and capacity-building for healthcare professionals at all levels to improve their clinical understanding of TB in the elderly and enhance the management of multiple morbidities.
- Improved Case Finding: Enhance case-finding efforts among the elderly through effective sputum collection and transportation systems. Establish mobile diagnostic vans and conduct active case finding at geriatric outpatient departments (OPDs), residential homes for the elderly, and other institutional settings.
- Clear Protocols: Develop technical and operational protocols that provide clear guidance on diagnosing and treating TB in the elderly, including sample extraction protocols, comprehensive assessment of comorbidities, and drug dosage adjustments.
- Socioeconomic Support: Design and implement support protocols that address the socioeconomic needs of elderly TB patients. Engage elderly individuals in the design of these support systems. Examples include elder-focused community care models, doorstep delivery of medicines, age-responsive peer support, counseling for older individuals and their families, special help desks for the elderly at healthcare facilities, and assistance with documentation to access social support schemes