The Opportunity in Geriatric Care in India

Old age in India is looked upon as a time meant for quiet contemplation, remembering the almighty and spending time harmlessly pottering around with ones grandchildren. While this idyll exists for some, the sad reality is that old age often means deteriorating health and illnesses. As one grows older the mind loses its agility, the body loses its vigour and diseases set in.

With nuclear families and double incomes being the norm in urban India, children caring for their parents find the going tough. It is not that they do not wish to look after the elderly, the problem is that juggling careers, children and parents needing constant medical attention becomes a difficult task. The situation gets further compounded if the elderly require constant medical attention.

Home care hardly exists in India. Even in a city like Delhi, getting adequate nursing care at home is next to impossible. While a handful of nursing services exist, their services are unreliable and offer dubious quality of care. These centres do not employ nurses trained in geriatric care, most of them are rejects from big hospitals and land up in these places because no one else is willing to hire them. Trusting, them to look after the elderly at home is a huge risk.

Old age homes too are hard to find.  A quick look up on Google threw up just 5 centres in Delhi, most run by NGO’s as not for profit centres. These homes too are more in the nature of shelters for the aged and are not equipped with round the clock medical care. If this is the state of affairs Delhi, one can easily assume the situation to be a lot worse elsewhere in the country.

To my mind this is a significant business opportunity, which can only grow.

Specialised Geriatric Care centres, will provide comprehensive care to the elderly. This would include day care as well as residential care centres. These centres need not be hospitals in the strictest sense of the word but specialised care centres equipped to take care of the day-to-day medical needs of the aged. Unlike hospitals these centres will not be only for those who are sick with a debilitating or terminal illness but for all those who need assisted living. Thus these centres will offer continuous care both in terms of managing day-to-day chores as well as state of the art medical care.

These centres can also run home care services for the elderly. They can provide trained people to look after the aged at their homes, particularly when the children are at work or traveling on business. This can work well for folks, who  have family around them and would like to spend their remaining days at home with them. It would also take away the feeling of guilt that most children, unable to take adequate care of their elderly  parents, suffer from.

A business model can be developed along these service lines and may include monthly charges for the stay in the centre and using its facilities and separate charges for medical interventions as and when needed. While these centres should be ‘for profit’, one has to handle the business sensitively. Compassion, kindness and a missionary sense of doing good must be critical business drivers along with profits.

I am of the view that these aims can be easily balanced and a ‘for profit’ organisation with compassion and kindness at its heart can be built and sustained.

Coping with Swine Flu in India

swine fluSwine flu has finally arrived in India.

So far 4 people have died and 782 people are confirmed to be infected with the virus and are undergoing treatment in designated government hospitals. The deaths have been in Pune, Mumbai and Ahmedabad, while Pune seems to be the worst hit. Strangely, school children appear to be seriously affected and many schools have shut down for a week or more.

Last week when I was in Mumbai a colleague called up in the evening. His 8 years old daughter was having a high fever and flu like symptoms. He had taken her to Max Hospital in Saket in New Delhi and he had been referred by the paediatrician to a government owned facility in Malviya Nagar for suspected swine flu. ‘The doctor did not even touch her, heard us while we explained the symptoms and promptly referred us to the government hospitals for tests. The government hospital admitted her for observation and now we do not know what to do. I fear even if my kid does not have swine flu, she is likely to catch it in the hospital’  explained my colleague Vijay Jain.

Another colleague in Mumbai, who was coughing and sneezing, had a bad throat and a fever decided not to come to work for a few days.  He felt that it wasn’t right for him to put others in office at risk.

These are tough calls. It is difficult for doctors to diagnose Swine Flu from the symptoms a patient presents. If the flu like symptoms are a little severe thay have no choice but to refer patients to the designated hospitals for tests, which means a patient has to visit a hospital, which has confirmed cases of Swine Flu and is therefore exposed to the disease. It is really a catch 22 situation.

In this situation the best thing to do would be to avoid going to busy public places, which are closed, particularly malls, airports, cinema theatres and yes offices and schools.

It would also help not to panic if one develops flu like symptoms. Afterall flu, that is the normal flu is a lot more prevalent than the swine flu and kills many more people every year. Mortality rate due to swine flu is still quite low, less than 7 per thousand. Statistically this is not a big cause of concern.

The government on its part must involve some private hospitals in combating the epidemic. It would help if a few private hospitals were allowed to test blood samples for the disease and admit patients in secluded wards. Large private hospitals are certainly more than capable of maintaining the records, treating the patients and ensuring that the disease remains in check. Additional testing and treatment centres will also help in instilling greater confidence in the public.

The government must also embark on a public awareness campaign. It must use mass media to educate the public about the disease, its symptoms, diagnostic procedure, treatment and prognosis. While I have noticed some advertising, it is hardly adequate.

Finally, the media must behave responsibly. In a situation like this it is indeed easy to create panic and cause mayhem by irresponsible journalism. It is the duty of all journalists to report objectively without resorting to unnecessary sensationalism and devoting too much media space to stories related to the spread of the disease.

Last but not the least, let us spare a thought for folks in the medical profession. They are at great personal risk in handling infectious patients. However, this is part and parcel of their calling. They must take all possible precautions, while providing succor and care to all those who seek their helHospital,p.

At the end of the day all of us are at risk. It is really up to us to exercise caution and help in whatever small way we can to fight the disease.

Pic courtesy http://www.flickr.com

Some names have been changed to protect privacy