The elderly population is an important demographic and socio-economic change in the 21st century that has had various impacts and opportunities for our society to serve them.

The government, health industry, and policymakers are facing a series of challenges today due to the increase in the elderly population, which poses a series of challenges to contribute to innovative, sustainable, cost-effective, and culturally appropriate care services to generate quality services for the elderly population.

According to the United Nations statistics, the number of older adults globally aged 65 years or older is projected to almost double from 727 million in 2020 to over 1.5 billion in 2050, which corresponds to an increase from 9.3% to 16.0%.

In addition, the population aged 60 and over should reach almost 2 billion by 2050 (United Nations, 2020). The rapid increase in population aging globally is causing all governments to struggle to cope, as they are struggling to cope with the consequences. (United Nations [UN], 2020).

India’s aging population in 2021 was 138 million people. However, as per the report prepared by the National Statistical Office (NSO)’s Elderly in India 2021, India’s elderly population will rise to 194 million in 2030 (the Citizen, July 27, 2022)

According to a government report on a technical group on population projections for India, in 2021 Kerala has the maximum share of the elderly population (16.5 %), followed by Tamil Nadu (13.6%) and Himachal Pradesh (13.1%). The least three states were Bihar (7.7%), Uttar Pradesh (8.1%) followed by Assam (8.2%).

According to projections for 2031, Kerala will have the highest percentage of elderly persons in its population (20.9%)

An elderly person’s instinct is to choose a comfortable and familiar environment for their final moments to achieve the best quality of life and well-being. The majority of elderly people possess a natural inclination to reside in their home, which they had laboriously built up in their early years of life, for as long as possible.

Regardless of age, the house is the place where you feel most comfortable and a ‘sanctuary’ where you feel safer. Various current studies worldwide indicate that the majority of our elderly population chooses to stay at home rather than move into aged care facilities.

The family is essential to supporting care for the elderly and its role is essential. It is high time for a comprehensive, family-centered, and community-connected in-home professional care services to improve the well-being of the elderly, and our current situation demands it.

It is, therefore, crucial to understand, accept, support, and educate caregivers or the family members who play an important role in the care of an elderly person; but unfortunately, this is a neglected area now and is also producing negative outcomes in the care structure.

Caregivers experience negative impacts on their physical health, mental health, financial status, community, and social lives, regardless of their care requirements. The quality and sustainability of care outcomes and home provision are negatively impacted by this.

The parents of many non-resident Indians are destined to live alone in their home country of India. Due to the increasing number of Indians migrating abroad for work, many elderly parents are left to deal with the challenges of aging alone.

There are countless elders in our country living alone, sometimes in areas so remote that even essentially needed services are not accessible to them.

Loneliness is an exceptionally difficult stage in the life of the elderly, attributed to reasons such as the loss of a life partner, the physical separation of children and limited mobility due to physical ailments and illnesses typical to old age.

Elder care will not be sustainable if consumers (and their families) are not confident in the quality of support and care provided

For most consumers, quality is not just about high-quality clinical care, although that is important, it is also primarily about their quality of life including choice and control in their lives.

Now is the time to educate society at large to reframe the attitude towards aging and elder care services. Ageing is a continuous process, and people can access a broad range of additional services to maintain their quality of life as they age. Care for the elderly must be a conversation at the community level that redefines the very concept of aging and care for the elderly.

The perception of care for the elderly must extend beyond an independently funded foreign system. Aging is a continuum, and rather than concentrating on government funding of an industry or system that deals with the elderly, the focus should be on what additional services elder people may need from a range of services in a market-based environment. subsidised as appropriate, to maintain the quality of their lives.

In short, the emphasis must shift from a supplier-centred to a consumer-centred approach.

To achieve the best outcome, a paradigm shift is needed for the current approach to elder care. Unfortunately, the most commonly used approach today is a disease-focused approach rather than a preventive care approach.

The primary health care system and the preventative approach are key to addressing the holistic needs of elderly people. It is time to think and act to replace the fragmented care system with a person-centered, family-centered and integrated care system that will be executed to offer the optimum and highest quality services to the elderly, based on moral ethics rather than worldly consideration.

When considering any form of care service, it is widely accepted that the best outcomes are achieved when a multidisciplinary team of mechanisms collaborates with one another to provide care that is integrated, evidence-based, and person-centric. To facilitate an evidence-based practice, it is important to conduct further research, ongoing assessment, teaching, counselling, training for professional development, upskilling and reskilling of the care teams that explicitly support enhancing a model of evidence-based decision-making.

To meet the expectations of the elderly and the community, it is essential to have reliable elder care service providers.

As a nation, India greatly respects diversity and at the same time provides opportunities and challenges for senior caregivers and policy makers to improve culturally appropriate services. A culturally appropriate service is defined as the ability of care providers and organizations to effectively provide care services that meet the social, cultural and linguistic needs of seniors.

In a typical elderly care system, consumers should have the power to choose their own care from a social, economic, and legal standpoint to determine what services they want to receive and from whom, for the cost they are willing to pay. Consumers’ choices should be a crucial factor in driving competition between providers, which will lead to increased effectiveness, efficiency, innovation, and quality. Unfortunately, many consumers are unable to exercise their freedom of choice due to lack of support and lack of empowerment.

In order to provide quality care to seniors, service providers must have a framework of policies and measures to protect them from exploitation and to live with freedom and dignity. A system may be even necessary for our younger generations to predict their aging period and take responsibility for contributing to their daily living costs and elder care services until the end of their lives.

The eldercare sector itself must be integrated into effective policy frameworks and resource funding. A well-written and well-structured organization policy can be beneficial to services in multiple ways. A written policy shows that the organization works efficiently and diligently, increasing stability and ensuring consistency in decision-making and is well positioned to execute operational procedures.

An elderly care service provider must maintain their quality and offer professional services while securing ongoing and secured funding. It is also important to maintain financial and organizational capacity through effective internal governance and policies, and competent management with an established professional services team.

Elder care services cannot be successful and sustainable unless families and seniors are confident in making their own choices and have the freedom to control their lives.

At the same time, our government has a challenging task for developing, implementing, and maintaining the quality of elderly care through an effective policy and monitoring framework. It is very important to have consistent and reliable quality standards and their enforcement.

The increasing number of seniors will also lead to an increase in demand for elderly care services, paving the way for adequate funding to offer quality care and support. In order to have a sustainable elder care service industry, it is necessary to have adequate funding, as well as a conducive environment and government policy settings.

The fundamental aspect of achieving sustainable funding provisions for elder care services is the balance between affordable, quality care and the elderly who can afford and contribute to the cost of the service. It is also important for the government to come up with an effective policy to offer subsidy services to the elderly population and to support them in receiving affordable services.

The share of the consumer contribution will not only improve the financial position of service providers, but will also contribute to improving the overall efficiency of the programme.

Innovation and social care funding partnership are crucial to facing the challenges of an aging population. To deliver sustainable, innovative, and high-quality services, providers require a long-term funding partnership. The eldercare sector needs reliable partners to fund for this social cause to provide innovative programs and quality care.

The world’s most daunting demographic challenge is not the rapid population growth anymore, but the alarming level of the aging population. It is vital to develop innovative systems, programes, and funding pools to address the challenges of contemporary demographic change.

References

https://indianexpress.com/article/cities/thiruvananthapuram/kerala-economic-review-2021-states-elderly-population-to-touch-21-by-2031-7816407/

https://www.deccanherald.com/opinion/in-perspective/sunset-years-with-sons-settled-abroad-797233.html

June 2022International Journal of Health Sciences

https://www.researchgate.net/publication/295622506_Research_report_on_Age_Identity_and_Social_Exclusion_Elderly_Persons_in_Kerala_A_Validation_of_Psychosocial_Model_of_Social_Exclusion

https://ijellh.com/wp-content/uploads/2014/07/27-293-303.pdf

https://ijellh.com/wp-content/uploads/2014/07/27-293-303.pdf

https://www.researchgate.net/journal/International-Journal-of-Environmental-Research-and-Public-Health-1660-4601

Bhatt AN et al. Int J Community Med Public Health. 2017 Apr;4(4):1213-1218

Kumar et al., 2012; HelpAge India, 2013; HelpAge India, 2014