Introduction :

The population of elderly persons is rapidly increasing globally. As per Census 2001, total population above 60 years of age in India was 76.6 million (7.5 %). The data of 2011 Census is yet not available, but as per projection, the elderly population as on date is expected to be around 98 million. At present pace of growth, it is likely to rise more rapidly in the coming years due to further increase in life expectancy. According to estimated projection, the population of elderly will be around 12.4 % of the total population by 2025.

The normal physiological aging process results in decrease in body stamina as well as immunity. This makes elderly more prone to diseases and disabilities. Around 8% elderly are bed ridden as per National Sample Survey Organization (NSSO). Elderly people suffer from complex health problem involving multiple organ and body system. Many of these require long term treatment or expensive interventions. The General health care delivery system which the elderly populations use at present is unable to meet the special needs of elderly population. Apart from this, with degradation in social and family values, the elderly are left alone to manage their own health problems. A dedicated health care system for elderly population is, therefore, essential.

Under such circumstances, it becomes the responsibility of the State to make suitable health care arrangement for the ailing elderly. It is high time the health care is geared to serve the requirements of the elderly and to meet the future challenge of rapidly increasing ageing society.

The objective of the NPHCE are :-

To provide easy access to preventive, promotive,

To make use of the community based primary health curative and rehabilitative services to the elderly care approach and strengthen capacity of the medical and paramedical professionals as well as the care-takers within the family for caring practices of the elderly.

To identify health problems in the elderly and provide appropriate health interventions in the community with a strong referral backup support

To provide referral services to the elderly patients through district hospital, medical colleges and strengthen health manpower development in the field of geriatric medicine.

Development of treatment models for the elderly persons in our country.

Strategies :

Preventive & promotive care

Management of illness

Health Manpower Development for geriatric services

Medical rehabilitation & therapeutic intervention

Developing appropriate training courses for medical and paramedical health professional in geriatric care

Promotion and encouraging basic, clinical, epidemiological and applied research in ageing and the health care of the elderly.

Integrating other systems of medicine such as AYUSH in provision of health care to the elderly


Packages of services to be made available at different levels under NPHCE

Health Facility Packages of services
Sub-centre Health Education related to healthy ageing Domiciliary visits for attention and care to home bound/bedridded elderly persons and provide training to the family care providers in looking after the disabled elderly persons. Arrange for suitable calipers and supportive devices from the PHC to the elderly disabled persons to make them ambulatory.

Linkage with other support groups and day care centres etc. operational in the area

Primary Health Centre Weekly geriatric clinic run by a trained Medical Officer Maintain record of the Elderly using standard format during their first visit Conducting a routine health assessment of the elderly persons based on a simple clinical examination relating to eye, BP, blood sugar, etc.

Provision of medicines and proper advice on chronic ailments.

Public awareness on promotional, preventive and rehabilitative aspects of geriatrics during health and village sanitation day/camps.

Referral for diseases needing further investigation and treatment, to Community Health Centre or the District Hospital as per need.

Community Health Centre First Referral Unit (FRU) for the Elderly from PHCs and below. Geriatric Clinic for the elderly persons twice a week. Rehabilitation Unit for physiotherapy and counseling

Domiciliary visits by the rehabilitation worker for bed ridden elderly and counseling of the family members on their home-based care.

Health promotion and Prevention.

Referral of difficult cases to District Hospital/higher health care facility

District Hospital Geriatric Clinic for regular dedicated OPD services to the Elderly. Facilities for laboratory investigations for diagnosis and provision of medicines for geriatric medical and health problems. Ten-bedded Geriatric Ward for in-patient care of the Elderly.

Existing specialities like General Medicine; Orthopaedics, Ophthalmology; ENT services etc. will provide services needed by elderly patients.

Provide services for the elderly patients referred by the CHCs/PHCs etc.

Conducting camps for Geriatric Services PHCs/CHCs and other sites.

Referral services for severe cases to tertiary level hospitals.

Activities up to Distric Hospital level :

District Hospital : Civil Hospital, Aizawl and Civil Hospital, Lunglei will be strengthened/upgraded for management of the elderly. It will have 10 bedded Geriatric Ward and run a Geriatric OPD on a daily basis for care of the elderly. There will be a dedicated Physiotherapy Unit. Support will be provided for Construction/renovation/extension of the existing building and furniture of Geriatric Ward and OPD, drugs and consumables, machinery, rehabilitative appliances, transport of referred/serious patients, IEC activities, home based care for bed ridden cases, contractual manpower; Consultants Medicine (2), Nurses (6), Physiotherapist (1), Hospital Attendants (2), and Sanitary Attendants (2), training of health professionals, miscellaneous cost for communication, TA/DA, POL, contingency etc.

Community Health Centres (CHCs) : Four (4) Community Health Centre in Aizawl District and one (1) Community Health Centre in Lunglei District will be covered under the programme in the Stae. Geriatric clinical will be held twice a week at CHCs. A Rehabilitation Worker will be employed on contract for Physiotherapy and medical rehabilitation services for the elderly. CHC will also be supported with certain appliances and aids for the elderly. Domiciliary visits for bed-ridden elderly and counseling to family members for home based care of such patients will be made by the rehabilitation worker. Support will also be provided for transport of referred cases, IEC activities, consumables etc.

Primary Health Centres (PHCs) : Ten (10) Primary Health Centre in Aizawl District and nine (9)Primary Health Centre in Lunglei District will be covered under the programmme in the State. PHC medical Officer will be in-charge for coordination, implementation & promoting health care of the elderly. A weekly geriatric clinic will be held at HHC level by trained Medical Officer. Support will be given for appliances and aids for the elderly. Home based care will be facilitated for bed ridden cases. Support will also be provided for transport of referred cases, IEC activities, consumables etc.

Sub Centres (SCs) : Ninety five (95) Sub Centre in Aizawl District and seventy one (71) Sub Centre in Lunglei District will be covered under the programme in the State. The ANM/Male Health Workers will be trained for health care of the elderly. Annual check-up of all the elderly at village level will be organized by PHC/CHC. Support will be given for certain appliances and aids for the elderly. Home based care will be facilitated for bed ridden cases. Support will also be provided for transport of referred cases, IEC activities, consumables etc.