For all the political discourse about a “population explosion”, the truth is that India is witnessing a sharp slowdown in its population growth and is expected to start reversing its numbers over the next 2-3 decades. According to a 2017 report by the United Nations Population Fund (UNFPA) around 12.5 per cent of India’s population will be 60 years and older by 2030; by 2050 this will increase to one fifth of the population.
With the total fertility rate (TFR) down to 2.3, we are very close to achieving replacement levels of population growth. A slowing population automatically implies a higher number of the elderly as against the young. According to the Economic Survey 2019, the country as a whole will continue to enjoy the “demographic dividend” for a few more decades but some states will start transitioning to an ageing society as early as the 2030s.
With declining fertility, reduction in mortality and increasing survival at older ages, the shift in age structure from young to old is expected to give rise to a major public healthcare burden. Unfortunately, we do not seem prepared to meet the requirements of this shift with little emphasis on improving our elderly care structure, health structure or building a social support system to address this shift.
The need is not limited to improving healthcare infrastructure and availability of caregivers for the elderly but also to create innovative social solutions to enable the elderly population live better, happier and more productive lives. ‘Social prescribing’ is a strategy that ageing countries are now incorporating in their policy to address the physical and mental health needs of the elderly and finding a way to address the problem of loneliness.
Social prescription for healthier ageing
In 2018, the British government initiated a new strategy to address the growing problem of loneliness among her country’s elderly. As part of this strategy that is expected to be fully in place by 2023, physicians will be allowed and encouraged to refer people to partake in social activities and social groups to combat loneliness. The strategy is aimed at reducing the burden on the British health service and improving patients’ quality of life.
This approach will be supplemented by investing in community projects such as creating cafes, art spaces or gardens that can become the focal point of the social prescriptions for the elderly.
This approach originates from the realization that additional to the medical needs of the elderly is the need to give them a good quality of life, happiness and greater social involvement. Currently, society treats the elderly with a peculiar redundancy. However, changing this approach could help convert a large experienced and wise population into valuable social capital, rather than just a healthcare burden.
Building a community referral system
Promoting healthy ageing can help delay the onset of disease and allow us to have a more productive population in their sunset years. Healthy ageing is essentially a process through which the elderly are enabled to optimize their physical and mental health and are able to take an active part in society. Community referrals are a mechanism to create and utilize social support structures for the elderly.
For example, an elderly couple living alone in a city away from their children can enjoy a much better quality of life if they are a regular part of a community exercise that allows them to pursue their passions and hobbies. This community referral system must also become an intrinsic part of the healthcare structure of our country whereby doctors are able to refer their elderly patients to the communities held suitable for them.
Joining communities and interest groups helps the elderly indulge in fruitful discussions, volunteer for social work and gives them hope and passion to live. Community groups can also be effectively leveraged to educate people to adopt healthy lifestyles and dietary habits that can enable them stay healthier and fitter for a longer period of time.
Need for public and private sector cooperation
This strategy cannot be achieved singularly by the government. Rather, it needs active participation of innovative start ups, social groups and volunteers to create a medical-social network requisite for social prescribing. Efforts are needed on multiple fronts to make this happen:
• Creating community group and social support networks to work in cohesion with hospitals and GPs
• Integrated awareness and training programmes to prepare a workforce that can act as a vital link between doctors and community groups and can play the role of counselors for the elderly
• Framing guidelines to help doctors recommend and refer patients to social networks
• Laying ground for coordinated a community-referral system at the levels of villages, towns and cities
• Engaging the local population, students and volunteers to spread the activities of community groups
Integrating social prescription with the healthcare structure will not only result in a healthier ageing population but also has the potential to reduce the financial burden on healthcare services.
This column was published in our print magazine. To buy a copy, click here
A thought leader in elderly care, Kewal Kapoor is the first person in India to advocate for creation of community based elder ecosystem in an innovative manner. The author is currently working to create and launch a technology-based innovative product and service to revolutionize the elderly care space in India.
Views of the author are personal and do not necessarily represent the website’s views.
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The CSR Journal Team