Dr Afshan Shabir –
In the Indian 2011 census, the elderly population age 60 and above accounted for 8.6% of the total population (103 million). This is projected to rise to 19.5% (319 million) by 2050. The proportion of people aged 75 and above is expected to increase by 340% between 2011 and 2050. The demographic/ epidemiological shift will further overburden our health care systems. The need of the hour is to promote ‘Healthy ageing’ as per WHO (decade commitment 2021-2030) to decrease the burden of chronic health conditions and improve quality of life of older persons. The Ministry of Health & Family Welfare had launched the “National Programme for the Health Care of Elderly” (NPHCE) during 2010-2011 to address various health-related problems of older people. The International Older person day was celebrated across the globe on 1st October. NPHCE in collaboration with WHO India held a multi-stakeholder dialogue on the UN theme for this year (Digital Equity for Older people). Digital platforms include social media, knowledge, media sharing and service-oriented platforms. It also includes the rapidly advancing sector of telemedicine, Artificial intelligence (AI) and Intelligent assistive technology (IAT). The COVID-19 pandemic has changed the spectrum of the digital world.
Loneliness is common in older people. The reason for this is multi-factorial: break down of extended family system, urban migration of children and over the last 2 years due to COVID-19 pandemic. The older person has multi-morbidities, physical impairments like visual, hearing, cognitive and mobility impairments due to which they feel isolated. Loneliness can have negative effects on the psychological and physical health of an older adult. The presence of loneliness is associated with cognitive impairment, decreased mobility and increased difficulties with activities of daily living. Digital engagements help older people to be more connected and keep them away from social isolation and improve their general perceived wellness and quality of life. Healthy Ageing India in association with the Ministry of Culture has initiated e-IGLM (Inter-generational Learning model) which provides a platform for older people to teach underprivileged school children. A similar initiative can be started in Kashmir by the stakeholders for both school/degree education and religious education. An ‘older person’ is a moving encyclopaedia and the younger generation can learn from their experiences.
Telemedicine is an Integrated Care service that involves the use of Information and Technology to deliver health care on a distant mode to patients separated from healthcare providers. During the COVID-19 pandemic, telemedicine services by healthcare staff including ours have helped thousands of patients especially older person. We have been able to advise treatment, counsel patients and demonstrate exercises for healthy living. Telemedicine has huge potential especially in treating complex older patients living in far-flung areas and the frail bed-ridden who can’t be transported to a tertiary care facility.
Artificial intelligence (AI) is heralding a new era of personalised medicine customised treatment for individual patients. AI has the potential to transform public health and prevent people from developing conditions. Intelligent assistive technology (IAT) can also be used in people with cognitive deficits. Multiple digital interventions are available in the market for home safety, personal safety and smart homes. Digital engagement provides access to senior citizens to participate in physical activities using motion sensors and other exergaming technologies.
The objective this year is that no one should be left out from digitalisation including the older person. As per an Indian study, there are 75 crore smartphones in India which is approximately 3 smartphones in every household i.e 55% of our population has access to smartphones. These can improve the quality of life of older persons. New smartphones are mini-computers, mini-radio and can be used for video conferencing. The older person no longer has to wait in long queues and be dependent on others. They can use smartphones to book railway/ air/ bus tickets, pay utility bills- electricity/ water/ TV, do online shopping for groceries/ medicines and other essential supplies by e-commerce and do banking transactions by e-banking. They can also use it to connect with their family/friends and health care workers.
There is a misconception that older persons especially >85 years of age cannot learn the use of digital platforms. Multiple studies have shown that older people are capable of learning new skills. We should motivate the family members especially the grandchildren to teach the older person to use digital technology. Also, Government can start age-appropriate training programs or workshops for older people to learn digital platforms so that they can be self-reliant and this ‘vulnerable’ cohort can be transformed into a ‘vital’ cohort.
The role of NGOs is immense. These can disseminate information through e-platforms and social media, digital training of community health workers, helping the elderly to use the tools. We should take feedback from senior citizens and identify barriers to using digital platforms. We have to ensure easy access, affordability and capacity building. Digital technology is emerging as a major solution to Healthy Ageing. The older person requires ongoing support from family members, healthcare professionals and society. The way forward is for all the stakeholders including Geriatricians, social services, NGOs, civil societies and the Government to collaborate to improve the services of older people and improve their quality of life.
(Dr Afshan Shabir, the author is working as Assistant Professor in Geriatric Medicine, Dept of Geriatric Medicine, Regional Geriatric Centre, SKIMS, Soura)