The government and the private sector should focus on developing geriatric medicines
At the age of 67, Shahnaz Akhtar, a retired public school teacher, has multiple health problems - she has diabetes and high blood pressure. She has consulted four specialists but has not felt any improvement in her health condition. After many visits to doctors and laboratory tests, she is now keen to consult one specialist that can cure all her ailments and charge a reasonable fee.
There is dire need for geriatric care in our country. It has not developed a specialty of geriatric diseases and healthcare in its medical institutions yet. The major reasons of neglect are: high expenses of healthcare in an unregulated health sector, low income, large families, and lack of awareness.
Dr Narmeen Hamid, a gender, health, and development consultant, says Pakistan has hardly any specialists on geriatric healthcare. "Unusually, geriatric patients are referred to general physicians in Pakistan as compared to developed countries that have introduced specialised geriatric medicine departments to deal with multiple diseases."
In Pakistan, she says, there are no proper institutions and departments to deal with physical and mental illness of the elderly.
"Pakistan is having the youth bulge at the moment and all policies are focused towards the youth but the state and society should also keep in mind that the same youth bulge, after a few decades, will greatly add to the number of senior citizens at the same time," she warns, adding, "The government and the non-government organisation should think on long term basis and create awareness about the issues and subjects related to elderly people."
She suggests that the private sector should come up with multi-care treatment plans if the government lacks resources in investing for geriatric healthcare. "This sector has a huge potential and can be made economically viable for non-affording senior citizens. There are profitable ideas on home-care service, too."
She also highlights the need of special trainings to deal with geriatric patients and for home-service treatment to them. "Healthcare providers are deficient in training to deal with elderly patients. There exists a need for training programmes and courses to improve the knowledge and skills," she says.
In 2013, recognising the provision of healthcare to senior citizens the Aga Khan University School of Nursing and Midwifery started offering a special training course, "Care of the elderly". The course has been specifically designed to provide training in geriatrics to nursing and non-nursing students at the undergraduate level for the first time in Pakistan.
The course aims to provide information for healthcare providers on the demographics of aging, age-related changes, medication use, and misuse, assessment of geriatric patients, supporting family caregivers and elder abuse.
A research report on the subject by the AKU finds that there is a lack of statistics about the old people in Pakistan. The study finds that a majority of elderly population has one or more chronic illness like diabetes, hypertension, and heart diseases, etc. They are vulnerable to various disabilities, nutritional challenges, and loss of independent functioning and depression as a consequence of complications arising from chronic diseases.
Little or no data is available about health and related issues concerning geriatric population in Pakistan. A recent hospital-based survey conducted by AKU in Karachi offers insight into the health status needs and issues confronting this highly vulnerable population. Over 40 per cent people above the age of 65 years were retired, establishing the need for elderly to have post-retirement support.
Dr Sibtul Hussnain, former head of Pakistan Medical and dental Council (PMDC) and Principal of Allama Iqbal Medical College, says, "there is no doubt that there is a great need for improved geriatric services and the area has not gotten attention at government or private level." He suggests the private sector should come up with plans. The government and philanthropists should subsidise that.
Challenges in mobility, urinary incontinence, fatigue, visual impairment, dementia, and depression are some of the common challenges faced by the elderly in Pakistan.