Geriatric health care - the road less traveled
- rajamohansub
- Feb 17
- 6 min read
I intend to start this blog with the following statement which exemplifies the importance of geriatric health care. "Hospitals are designed for emergencies, cities for speed, technology for youth, but we often forget those who moves slowly, hear softly, remember feebly and feels deeply'. Perhaps that is why Geriatric health care remains a road less traveled.
The unique Indian value system of 'Joint family' which existed till one/two generations back, provided quality geriatric heath care to the elderly in India in their homes itself, in addition to emotional, social, financial and maintenance securities provided to them with out any expectations. The moment the 'nuclear family' concept took precedence over the 'Joint family' concept most of the the elders are left in lurch.
Before the arrival of allopathic (western) system of medicine in India, Indians used many traditional plant based medicines for the general and geriatric health care. Siddha medicine (சித்த மருத்துவம்),one of the oldest traditional medicines, supported geriatric health through plant based medicines, rejuvenation therapies (Kayakalpa), diet rules ( உணவே மருந்து), yoga and management of health related diseases.
Dr. Ignatz Nascher , an Austrian - American physician coined the word ' Geriatrics' in his 1914 text ' Geriatrics : The diseases of old age and their treatment'. The growth of geriatric medicine was slow and only in 1966 the first geriatric medicine fellowship program was started in the City Hospital Center, New York
Madras Medical College ( MMC) has the distinction of starting the first geriatric outpatient facility in India,in 1978 and the same college has the distinction of staring the first MD program in Geriatrics in 1996.
The longevity of human beings increased over the centuries due to improved living conditions, improved health care facilities,decrease in infant mortality and decrease in infectious diseases. It is evident even in my family as well, as my father lived up to 90 years and my mother is 91 years old and leading a healthy life.
1.Demographic shift:
As per World Health Organization's ( WHO) report dated October 2025, people worldwide are living longer, and between 2015 and 2050 the proportion of the world's population over 60 years will nearly double from 12% to 22%. ( about 2.1 billion)
Population ageing, the shift in the distribution of a country's population towards older ages started in high income countries (e.g. Japan's 30% of its population is already over 60 years old). It is now that the low and middle income countries are experiencing the greatest change. By 2050 , two thirds of the world population over 60 years will live in low and middle income countries.
As per Government of India's press release dated 28th October 2025, India's senior citizens (60 years and above) population will make up about 15% of the total population by 2036 and southern states along with Himachal Pradesh and Punjab will have higher elderly population
During the same time period, Tamil Nadu's elderly population will surge to 21% of the total population (second only to Kerala, whose elderly population will be 23%) with the state's median age will rise to 40.5 years.
To tackle this demographic shift, are the world, India and Tamil Nadu ready?. Let us ponder over.
2 .Geriatrics health care challenges :
The above said demographic shift poses many challenges to the Governments and to the society as a whole. At present, the world's health system is youth - centric and less focused on geriatric health even though a paradigm shift is happening in the world's demography towards ageing population. Geriatric heath care requires unique solutions to chronic diseases, mental and emotional support systems by providing care oriented medicines.
Geriatrics health care is multicomplex and it addresses older patient's 'mind, mobility , medications, multi complexity and what matters most ' (5 Ms) as launched by the Canadian and the US specialists in 2017.
Source : The college of Family physicians of Canada
As per WHO's Active ageing framework released on 2002, major chronic conditions affecting older people worldwide are musculoskeletal conditions (such as arthritis and osteoporosis) , mental health conditions (mostly dementia and depression),blindness and visual impairment, chronic obstructive pulmonary disease, cardiovascular diseases (such as coronary heart disease, hypertension, diabetes, stroke and cancer
Following simple steps will avoid missteps in old age
Preventing physical missteps :
Regular walking (30 minutes, if possible)
Chair squats, heel raises
Review medications regularly
Make the home fall-proof
Annual eye check and hearing assessment
Nutrition for bone health
Avoiding health symptoms;
Do not ignore early symptoms like memory changes, sleep disturbance, breathlessness
Focus on function, stay independent
Stay mentally active by reading, writing and learning new skills and continue social interaction
Avoiding emotional and social misstep
Avoid social isolation by doing volunteer work, joining community club
Accept support gracefully (Independence is important but safety is foremost)
Avoiding financial missteps
Be cautious with scams
Always keep emergency fund
Avoid unknown calls
Avoid cognitive missteps
Take regular cognitive screening (memory tests, sleep evaluation)
Manage chronic conditions which affect cognition (uncontrolled diabetes, High Bp , thyroid issues
3. Geriatric systems/policies worldwide:
Internationally, geriatrics health systems (in various forms) have been in existence for quite some time, but codified, systematic and regulated geriatrics came into being only in the 20th century. The growth of geriatrics is not uniform in all the countries and there are wide gaps between developed and developing countries not to mention about the under developed countries .
In Europe and the USA, institutionalized geriatrics education started in 1950 -1960s and the American geriatrics society was formed in 1942 and the British geriatrics society in 1947. The International Council on Active Ageing (ICAA), a professional association was founded in 2001 and WHO"s Active Ageing Framework was released on 2002. https://extranet.who.int/agefriendlyworld/wp-content/uploads/2014/06/WHO-Active-Ageing-Framework.pdf
WHO initiated a collaborative action plan of 'Decade of Heathy Ageing' ( 2021-2030) following the UN General Assembly (GA) resolution (Resolution 75/131) targeting four key areas: ageing, age-friendly environments, integrated care and long -term care
Geriatric systems in India:
In line with the development and progress of geriatrics education and facilities worldwide (especially in the western world) , India's few educational institutions introduced elective teaching on ageing in 1980-2000s. Madras (Chennai) is the pioneer in starting the first geriatric outpatient facility in Madras Medical College ( MMC) in1978 and the first MD course in1996.
As mandated in the Constitution of India, article number 41, India introduced its first National policy for older persons in 1999. https://socialjustice.gov.in/writereaddata/UploadFile/National%20Policy%20for%20Older%20Persons%20Year%201999.pdf
Structured development of geriatrics started only after the launching of ' National Program for the Health Care of the Elderly' (NPHCE) in 2010. As a part of this program, various National centers of Ageing (tertiary level hospitals with multi disciplinary clinics) have been planned through out India and one such center has come up in Guindy, Chennai in coordination with the Tamil Nadu government.
The 200 bed modern multispecialty hospital (first of its kind in India) at Guindy, Chennai was commissioned on 25th February 2024. I have visited the facility on the second week of November 2025 and was impressed by the free medical and other facilities provided to the elderly patients. As the facility is up and running, there is a scope for improvement for staffing specialty doctors.
Psychological and emotional support system
The video below explains the scientific reasons behind each of the 12 common issues of the seniors like forgetting to brush the teeth in the morning, repeating the same story every now and then, complaining about every small things which make a senior citizen uncomfortable etc. Treating them at the early stage will help the seniors regain confidence and pursue independence
Gentle humor and quotes about geriatrics
Patient : Doctor, the new hearing aid is amazing.
Doctor: Wonderful, what kind is it?
Patient: Quarter past three
It is only in geriatrics that the patient may have more life experience than the attending health professional.
By the time you are 80, you have learned everything, You only have to remember it
ஆரோக்கியத்தை விட மற்ற எதுவுமே பெரிதில்லை என்பதை மருத்துவமனை புரிய வைக்கும்
7.Do you know :
Geriatrics ; the diseases of the old age and their treatment (1914) by Dr. Ignatz Nascher is considered as the first modern geriatric book .
The word 'Geriatrics' is derived from two Greek words. geras (old age) and iatrikos (physician/healer)
The global geriatric care services market is projected to reach over $1.6 - 2.4 trillion by 2030 -31
Thanks Lingam for highlighting the importance of geriatrics in the society and encouragement required to help the elders to live their life to the fullest.
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